HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Sacco, R. L. Search for Related Content PubMed PubMed Citation Articles by Sacco, R. L.

Identifying patient populations at high risk for stroke

From the Department of Neurology and Public Health (Epidemiology), the Sergievski Center, and the Neurological Institute, College of Physicians and Surgeons of Columbia University, New York, NY.

Address correspondence and reprint requests to Dr. Ralph L. Sacco, Columbia-Presbyterian Medical Center, College of Physicians and Surgeons of Columbia University, 710 West 168th Street, Room 547, Box 6, New York, NY 10032.

Abstract.

Although the treatment of acute ischemic stroke has improved, the greatest reductions in stroke mortality and morbidity may possibly be achieved through more effective prevention strategies. Toward this goal, risk factor profiles for initial and recurrent stroke have been identified through longitudinal epidemiologic studies. Nonmodifiable risk markers for initial ischemic stroke include age, sex, family history, and race/ethnicity. Modifiable risk factors for first ischemic stroke include hypertension, cardiac disease (particularly atrial fibrillation), diabetes, hyperlipidemia, cigarette smoking, alcohol abuse, physical inactivity, asymptomatic carotid stenosis, and transient ischemic attack. As improved acute treatments increase survival after a first stroke, the threat of increased morbidity from stroke recurrence will have greater significance. The risk and specific determinants of early and late stroke recurrence are the subject of ongoing investigations. Age, stroke syndrome, hypertension, cardiac disease (particularly congestive heart failure), hyperglycemia, and alcohol abuse have been identified as predictors of late stroke recurrence. Now that many risk factors are established, greater emphasis should be placed on identifying high stroke-risk patient populations for intensive risk factor modification and antithrombotic treatments. Better understanding and management of stroke risk factors will undoubtedly improve our ability to prevent first and recurrent ischemic stroke.

This article has been cited by other articles:

				H. Sillesen, P. Amarenco, M. G. Hennerici, A. Callahan, L. B. Goldstein, J. Zivin, M. Messig, K. M. Welch, and on Behalf of the SPARCL Investigators Atorvastatin Reduces the Risk of Cardiovascular Events in Patients With Carotid Atherosclerosis: A Secondary Analysis of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Trial Stroke, December 1, 2008; 39(12): 3297 - 3302. [Abstract] [Full Text] [PDF]

				H. J. Fullerton, Y. W. Wu, S. Zhao, and S. C. Johnston Risk of stroke in children: Ethnic and gender disparities Neurology, July 22, 2003; 61(2): 189 - 194. [Abstract] [Full Text] [PDF]

				H.J. Fullerton, D.M. Chetkovich, Y.W. Wu, W.S. Smith, and S.C. Johnston Deaths from stroke in US children, 1979 to 1998 Neurology, July 9, 2002; 59(1): 34 - 39. [Abstract] [Full Text] [PDF]