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Stroke Prevention in Older Adults: Recent Advances.
Spence, J David; Azarpazhooh, M Reza; Larsson, Susanna C; Bogiatzi, Chrysi; Hankey, Graeme J.
Afiliação
  • Spence JD; Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, ON, Canada (J.D.S., M.R.A.).
  • Azarpazhooh MR; Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, ON, Canada (J.D.S., M.R.A.).
  • Larsson SC; Unit of Nutritional Epidemiology, Karolinska Institutet, Stockholm, Sweden (S.C.L.).
  • Bogiatzi C; Department of Neurology, McMaster University, Hamilton, ON, Canada (C.B.).
  • Hankey GJ; Department of Neurology, The University of Western Australia, Perth (G.J.H.).
Stroke ; 51(12): 3770-3777, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33121384
ABSTRACT
The risks of stroke and dementia increase steeply with age, and both are preventable. At present, the best way to preserve cognitive function is to prevent stroke. Therapeutic nihilism based on age is common and unwarranted. We address recent advances in stroke prevention that could contribute greatly to prevention of stroke and dementia at a time when the aging of the population threatens to markedly increase the incidence of both. Issues discussed (1) old patients benefit even more from lipid-lowering therapy than do younger patients; (2) patients with stiff arteries are at risk from a target systolic blood pressure <120 mm Hg; (3) the interaction of the intestinal microbiome, age, and renal function has important dietary implications for older adults; (4) anticoagulation with direct-acting oral anticoagulants should be prescribed more to old patients with atrial fibrillation; (5) B vitamins to lower homocysteine prevent stroke; and (6) most old patients in whom intervention is warranted for carotid stenosis would benefit more from endarterectomy than from stenting. An 80-year-old person has much to lose from a stroke and should not have effective therapy withheld on account of age. Lipid-lowering therapy, a more plant-based diet, appropriate anticoagulation or antiplatelet therapy, appropriate blood pressure control, B vitamins to lower homocysteine, and judicious intervention for carotid stenosis could do much to reduce the growing burden of stroke and dementia.
Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Idioma: Inglês Revista: Stroke Ano de publicação: 2020 Tipo de documento: Artigo

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Idioma: Inglês Revista: Stroke Ano de publicação: 2020 Tipo de documento: Artigo
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