Cardiovascular Risk Factor Management in the Prevention of by P. Amarenco

By P. Amarenco

Collected listed here are the findings of the satellite tv for pc symposium hung on the social gathering of the eleventh eu Stroke convention.

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Extra info for Cardiovascular Risk Factor Management in the Prevention of Stroke (Cerebrovascular Diseases)

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Diabetes Care 2001;24: 1335–1341. Cerebrovasc Dis 2003;16(suppl 3):25–32 30 Berenson GS, Srinivasan SR, Bao W, Newman WP III, Tracy RP, Wattigney WA, for the Bogalusa Heart Study: Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. N Engl J Med 1998;338:1650–1656. 31 Smilde TJ, Van Wissen S, Wollersheim H, Trip MD, Kastelein JJP, Stalenhoef AHP: Effect of aggressive versus conventional lipid lowering on atherosclerosis progression in familial hypercholesterolaemia (ASAP): a prospective, randomised, double-blind trial.

4). The ASAP trial is important as the regression in carotid IMT associated with aggressive atorvastatin therapy may result in a significant reduction in cardiovascular events, and in 30 Cerebrovasc Dis 2003;16(suppl 3):25–32 younger adults may ameliorate the atherosclerotic process before the development of symptomatic disease. To date, statin studies have only been conducted in patients with or at high risk for CAD. These patients are not wholly representative of the overall stroke population.

The trial has randomised approximately 8,600 patients with coronary artery disease to either atorvastatin 80 mg/day or simvastatin 20 mg/ day. Patients receiving simvastatin will be titrated to the 40 mg/day dose if total cholesterol levels remain 1193 mg/dl (5 mmol/l). As with the TNT trial, primary endpoints are the incidence of non-fatal MI and fatal coronary artery disease (CAD). How early should we start lipid-lowering therapy? Autopsy studies have demonstrated that the atherosclerotic process begins during adolescence with the appearance of fatty streaks and fibrous plaques in the aorta, coronary arteries and cervical carotid arteries [30].

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