2010年美国心脏病协会.docVIP

2010年美国心脏病协会/卒中协会卒中一级预防指南 （全文见附件） 推荐要点 Guidelines for the Primary Prevention of Stroke. Generally Nonmodifiable Risk Factors Age N/A Sex N/A Low birth weight N/A Race/ethnicity N/A Genetic factors Recommendations 1. Obtaining a family history can be useful to help identify persons who may be at increased risk of stroke (Class IIa; Level of Evidence A ). 2. Genetic screening of the general population for prevention of a first stroke is not recommended (Class III; Level of Evidence C ). 3. Referral for genetic counseling may be considered for patients with rare genetic causes of stroke (Class IIb; Level of Evidence C ). 4. Treatment for certain genetic conditions that predispose to stroke (eg, Fabry disease and enzymereplacement therapy) might be reasonable but has not been shown to reduce risk of stroke, and its effectiveness is unknown (Class IIb; Level of Evidence C ). 5. Screening of patients at risk for myopathy in the setting of statin use is not recommended whenconsidering initiation of statin therapy at this time (Class III; Level of Evidence C ). 6. Noninvasive screening for unruptured intracranial aneurysms in patients with 1 relative with SAH or intracranial aneurysms is not recommended (Class III; Level of Evidence C ). 7. Noninvasive screening for unruptured intracranial aneurysms in patients with 2 first-degree relatives with SAH or intracranial aneurysms might be reasonable (Class IIb; Level of Evidence C ). 8. Universal screening for intracranial aneurysms in carriers of mutations for Mendelian disorders associated with aneurysm is not recommended (Class III; Level of Evidence C ). 9. Noninvasive screening for unruptured intracranial aneurysms in patients with ADPKD and 1 relatives with ADPKD and SAH or intracranial aneurysm may be considered (Class IIb; Level of Evidence C ). 10. Noninvasive screening for unruptured intracranial aneurysms in patients with cervical fibromuscular dysplasia may be considered (Class IIb; Level of Evidence C ). 11. Dosi