Skip to Main Content

++

KEY POINTS

++

  • Patients who have had a stroke or transient ischemic attack are at risk for recurrent stroke, myocardial infarction, and death.

  • Smoking cessation, exercise, and weight management are beneficial lifestyle modifications for stroke survivors. MTM providers should reinforce the importance of lifestyle modifications and incorporate these elements, as appropriate, into the medication action plan.

  • Antihypertensives, statin therapy, antiplatelet agents, and anticoagulants are evidence-based therapies proven to reduce the risk of recurrent stroke. MTM providers should review the medication profile of stroke survivors to identify potential gaps in therapy.

++

INTRODUCTION TO STROKE

++

A leading cause of death and disability, stroke affects 800,000 Americans each year.1, 2 It is estimated that every 40 seconds, someone in the United States has a stroke, and every 4 minutes, someone dies as a result of a stroke. The majority of strokes are ischemic in nature. Figure 35-1 outlines a classification of stroke by mechanism.2

++
Figure 35-1.

A Classification of Stroke by Mechanism

Source: Fagan SC, Hess DC. Stroke. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 8th ed. New York, NY: McGraw-Hill; 2011. Chap 27 Available at http://accesspharmacy.mhmedical.com/book.aspx?bookID=689. Accessed March 16, 2013.

Graphic Jump Location
++

Risk factor modification is paramount for stroke prevention; risk factors for stroke are listed in Table 35-1. Patients who have had a stroke or transient ischemic attack (TIA) are at risk for recurrent stroke, myocardial infarction, and death.1 For patients who have had a stroke, adherence to evidence-based treatment guidelines can prevent death, reduce disability, and improve outcomes. The acute management of stroke is beyond the scope of this chapter. Instead, the focus includes secondary prevention of stroke in the outpatient setting.

++
Table Graphic Jump Location
Table 35-1.Risk Factors for Ischemic Stroke

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.