To review trials involving risk factor management and pharmacologic therapy for the prevention of stroke.
DATA SOURCES:
English-language literature published between 1966 and 1992 was analyzed; pertinent literature is reviewed.
STUDY SELECTION:
Studies that evaluated the impact of risk factor management on prevention of vascular events were selected. In addition, trials assessing the safety and efficacy of pharmacologic intervention in primary and secondary stroke prevention were evaluated.
DATA EXTRACTION:
Trials were evaluated for their ability to demonstrate a decrease in stroke occurrence.
DATA SYNTHESIS:
Various trials were analyzed in several categories. Studies evaluating risk factor management of hypertension and cardiogenic cerebral emboli were reviewed and recommendations made based on a consensus of these trials. The use of antiplatelet agents in stroke prevention was addressed by a review of pertinent trials and meta-analyses.
CONCLUSIONS:
The control of risk factors and the use of antiplatelet agents significantly reduces the risk of vascular events. Benefit from different therapies may be specific to certain patient populations and recommendations are made for these patients.
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