Abstract. Stroke is a major cause of mortality and disability worldwide. During the past three decades, major advances have occurred in secondary prevention, which have demonstrated the broader potential for the prevention of stroke. Risk factors for stroke include previous stroke or transient ischemic attack, hypertension, high blood cholesterol and diabetes. Proven secondary prevention strategies are antiplatelet agents, antihypertensive drugs, statins and glycemic control. In the present review, we evaluated the secondary prevention of stroke in light of clinical studies and discuss new pleiotropic effects beyond the original effects and emerging clinical evidence, with a focus on the effect of optimal oral pharmacotherapy.
Contents1. Introduction 2. Antiplatelet agents 3. Antihypertensive drugs 4. Statins 5. Glycemic control 6. Conclusion
IntroductionStroke is one of the leading causes of disability worldwide (1). In 2002, stroke-related disability was estimated to be the sixth most common cause of reduced disability-adjusted life-years (DALYs; the sum of life-years lost as a result of premature mortality and years lived with disability adjusted for severity) (2). However, due to the burgeoning elderly population in Western societies, it has been estimated that by 2030, stroke-related disability in such societies will be the fourth most significant cause of DALYs (3). Stroke also has substantial costs related to complications, including poststroke dementia, depression, falls, fractures and epilepsy (4). Risk factors and sources of stroke must be identified in order to take steps towards preventing stroke (5). Although primary prevention is most significant in the reduction of stroke burden, effective secondary prevention is also essential (4). Secondary prevention addresses all measures for avoiding recurrences following a first transient ischemic attack (TIA) or