Stroke Prevention Therapy
Most stroke is due to furring up (atheroma) of the blood vessels to the brain. In this case there are well-proven treatments to help prevent further trouble, including smoking cessation, blood pressure control, cholesterol lowering, dietary changes, aerobic exercise and drugs like Aspirin or Clopidogrel, that make the blood clotting cells (platelets) less “sticky”.
Many patients in the community who are on blood pressure or cholesterol lowering treatment will be benefitting somewhat, but if proper targets are not reached, then they may be missing out on potential risk reductions. Optimal blood pressure is less than 130/80, and if the blood pressure is not lowered to this level, there is ongoing risk of stroke. Cholesterol targets should be less than 4.0 for those with a history of stroke or heart attack.
For some with other causes of stroke additional treatments should be considered;
Closure of “hole in the heart”
for those with a Patent foramen Ovale (PFO) or Atrial Septal Defect (ASD)
Blood thinning with Warfarin or New Oral
Anticoagulants
For those with Atrial Fibrillation (AF) and PFO (who do not want a closure
procedure)
Left Atrial Appendage Occlusion
For those who cannot or do not want to take warfarin, but are at risk of stroke
from AF.