缺血性脑血管疾病的二级预防（65p）.pptVIP

衡量任何政府成功或失败的最终评估标准应是其国民的满意度. 对政府而言,没有什么事情会比大众的健康更为重要,政府最关心的应是它的人民的健康. Franklin Delanor Roosevelt (1932) 卒中的危害性巨大，卒中具有多种危险因素 卒中是可以预防的，预防必须是循证的 病因分层是重要的发展方向 卒中预防必须依靠系统来实现 总 结 问 题 ？ * * The recommendations for secondary prevention included in these guidelines are listed on this slide. At the top are the recommended approaches to risk factor reduction and life-style modification, followed by specific interventions studied to reduce risk. Carotid artery interventions include carotid endarterectomy and stenting. Specific recommendations are provided for the use of antithrombotic medications (both antiplatelet and anticoagulant), statins and blood pressure lowering with diuretics and ACE inhibitors. The use of angiotensin receptor blockers (ARBs) are also included. * This slide summarizes the relative risk reduction with secondary prevention therapies for ischemic stroke based on meta-analysis of existing trials. There are a number of medical therapies as well as life-style modifications that have been proven to reduce the risk of recurrent stroke. Applying these risk-reducing therapies to appropriate patients, in the absence of contraindications, could result in major benefits to patients hospitalized with stroke. * The HOPE trial, a secondary prevention study of patients with vascular disease or diabetes, including some stroke patients, showed reduction of events using the ACEI ramipril as monotherapy1. A primary prevention study in patients with hypertension and left ventricular hypertrophy, the LIFE trial, found the ARB losartan perferable to the beta-blocker atenolol, even though both achieved the same blood pressure control2. More recently, the MOSES trial, a prospective, randomized trial of hypertensive patients with a history of a cerebrovascular event within 24 months prior to randomization, found the ARB eprosartan reduced recurrent stroke significantly better than the calcium channel blocker nitrendipine despite equal blood pressure control3. 1The