Cutting the Risk of Recurrent Stroke
Dr Robert Welding
Any person who has suffered a stroke or a mini-stroke will need risk factors assessed by a doctor to reduce the chance of another attack.
The doctor will suggest lifestyle changes such as stopping smoking and weight reduction in obesity. If the patient has diabetes the blood glucose will need control through diet and sometimes also with tablets or insulin. The blood pressure will need checking, and reduced if high.
Most patients who have suffered an attack will need to take an aspirin based drug, plus a statin drug to reduce cholesterol even if the cholesterol is already low. The doctor will also need to start an ACE inhibitor drug such as ramipril or perindopril. This will help by lowering blood pressure, but is also believed to have an additional protective role.
A few patients will need a carotid endarterectomy. This is an operation to open up the main blood vessel to the brain if it is narrowed. A simple ultrasound scan measures the blood flow in the carotid artery, and if there is narrowing then a surgeon will assess the need for surgery.
We now co-ordinate these assessments in Rapid Access Clinics in the hospital out-patients department.