Chinese Guidelines for the Secondary Prevention of Ischemic Stroke and Transient Ischemic Attack 2010

• Published in: CNS neuroscience & therapeutics 2012-02, Vol.18 (2), p.93-101
• Main Authors: Wang, Yong-Jun, Zhang, Su-Ming, Zhang, Liqun, Wang, Chun-Xue
• Format: Article
• Language: English
• Subjects: Arteriosclerosis; Atherosclerosis; Bacterial diseases; Bacterial diseases of the nervous system. Bacterial myositis; Biological and medical sciences; Blood pressure; Blood. Blood coagulation. Reticuloendothelial system; Cardiovascular disease; China - epidemiology; Cholesterol; Clinical Guidelines; Coronary artery; Diabetes; Diabetes mellitus; Disease prevention; Drug dosages; Epidemiology; Glucose; Guideline; Health risk assessment; Heart diseases; Hemoglobin; Human bacterial diseases; Humans; Hypertension; Impact strength; Infectious diseases; Ischemia; Ischemic Attack, Transient - diagnosis; Ischemic Attack, Transient - epidemiology; Ischemic Attack, Transient - prevention & control; Ischemic stroke; Lifestyles; Lipids; Low density lipoprotein; Medical sciences; Metabolic syndrome; Morbidity; Mortality; Neurology; Pharmacology. Drug treatments; Plaques; Population; Prevention; Risk factors; Secondary Prevention - standards; Statins; Stroke; Stroke - diagnosis; Stroke - epidemiology; Stroke - prevention & control; Thrombosis; TIA; Transient ischemic attack; Vascular diseases; Vascular diseases and vascular malformations of the nervous system
• ISSN: 1755-5930; 1755-5949; 1755-5949
• DOI: 10.1111/j.1755-5949.2011.00290.x

The risks of recurrent stroke are different, because the causes and the pathophysiological mechanisms of ischemic stroke/transient ischemic attack (TIA), the locations of vascular diseases, risk factors, and patients’ compliance are so variable. Studies in China suggest a logistic relationship between elevated blood pressure (BP) and the risk of stroke [ 2]: for every 10 mmHg elevation of systolic BP from baseline, the relative risk of stroke increases 49%; for every 5 mmHg elevation of diastolic BP, the relative risk of stroke increases 46%. 2 For patients with stroke/TIA and multiple risk factors (such as coronary artery disease, diabetes, current smoking, metabolic syndrome, cerebrovascular atherosclerosis without evidence of unstable plaque, arterial thrombosis or peripheral arterial disease), it is reasonable to target a LDL‐C level of 40% in LDL‐C (Class I, Level of Evidence A). 3 Patients with ischemic stroke/TIA and evidence of intra‐ and extracranial large artery atherosclerosis and unstable plaques or arterial thrombosis, are recommended early intensive statin therapy to target a LDL‐C level of 40% in LDL‐C (Class III, Level of Evidence C).