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Cited by 473

The DOI matches its Crossref record; 7 of the 7 references it cites were found in a registry or an index.

Prevention of a First Stroke: A Review of Guidelines and a Multidisciplinary Consensus Statement From the National Stroke Association

Gorelick, Philip B., Sacco, Ralph L., Smith, Don B., Alberts, Mark, Mustone-Alexander, Lisa, Rader, Dan, Ross, Joyce L., Raps, Eric, Ozer, Mark N., Brass, Lawrence M., Malone, Mary E., Goldberg, Sheldon, Booss, John, Hanley, Daniel F., Toole, James F., Greengold, Nancy L., Rhew, David C.·1999·JAMA
DOI 10.1001/jama.281.12.1112
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Abstract

OBJECTIVE: To establish, in a single resource, up-to-date recommendations for primary care physicians regarding prevention strategies for a first stroke. PARTICIPANTS: Members of the National Stroke Association's (NSA's) Stroke Prevention Advisory Board and Cedars-Sinai Health System Department of Health Services Research convened on April 9, 1998, in an open meeting. The conference attendees, selected to participate by the NSA, were recognized experts in neurology (9), cardiology (2), family practice (1), nursing (1), physician assistant practices (1), and health services research (2). EVIDENCE: A literature review was carried out by the Department of Health Services Research, Cedars-Sinai Health System, Los Angeles, Calif, using the MEDLINE database search for 1990 through April 1998 and updated in November 1998. English-language guidelines, statements, meta-analyses, and overviews on prevention of a first stroke were reviewed. CONSENSUS PROCESS: At the meeting, members of the advisory board identified 6 important stroke risk factors (hypertension, myocardial infarction [MI], atrial fibrillation, diabetes mellitus, blood lipids, asymptomatic carotid artery stenosis), and 4 lifestyle factors (cigarette smoking, alcohol use, physical activity, diet). CONCLUSIONS: Several interventions that modify well-documented and treatable cardiovascular and cerebrovascular risk factors can reduce the risk of a first stroke. Good evidence for direct stroke reduction exists for hypertension treatment; using warfarin for patients after MI who have atrial fibrillation, decreased left ventricular ejection fraction, or left ventricular thrombus; using 3-hydroxy-3 methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors for patients after MI; using warfarin for patients with atrial fibrillation and specific risk factors; and performing carotid endarterectomy for patients with stenosis of at least 60%. Observational studies support the role of modifying lifestyle-related risk factors (eg, smoking, alcohol use, physical activity, diet) in stroke prevention. Measures to help patients improve adherence are an important component of a stroke prevention plan.

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Metadata

Authors
Gorelick, P. B., Sacco, R. L., Smith, D. B., Alberts, M., Mustone-Alexander, L., Rader, D., Ross, J. L., Raps, E., Ozer, M. N., Brass, L. M., Malone, M. E., Goldberg, S., Booss, J., Hanley, D. F., Toole, J. F., Greengold, N. L., & Rhew, D. C.
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
1999-03-24
Volume
281
Issue
12
Pages
1112
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.281.12.1112
OpenAlex
W2135902934
Cited by
473
References
7
FWCI
35.21
Type
journal article
Language
en
Open access
closed

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