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Medical Conditions

Risk factor control to prevent a first stroke (primary prevention)

Medical
Conditions
Therapeutic
Goal
Measures
Hypertension  Decrease build-up of atherosclerotic plaque; reduce direct damage to walls of small arteries and arterioles

 Lifestyle modifications and antihypertensive medications reducing blood pressure to <140/90 mmHg

Diabetes Mellitus

 Decrease rate of atherosclerosis, and its secondary consequences such as hypertension

 Diet, oral hypoglycemics, or insulin to reduce or normalize blood glucose levels if possible

Hyperlipidemia  Reduce or prevent atherosclerotic plaque formation

 Diet limiting fats, increased physical activity, possible use of a statin or other lipid-lowering agent

Carotid Artery Stenosis (asymptomatic)  Prevent thrombus forming on existing atherosclerotic plaque
• 
Improve blood flow by increasing size of lumen
 Antiplatelet agents
 Endarterectomy or angioplasty; possible plaque reduction by diet and statins
Heart Disease
Acute MI-especially if anterior or septal region of heart wall is damaged  Prevent thrombus from forming on ischemic endocardium  Oral anticoagulant or antiplatelet agents
Conditions, including MI, that reduce motion of the heart wall  Prevent thrombus from forming in ventricle  Oral anticoagulant (preferred) or antiplatelet agent
Atrial 
Fibrillation
• Restore normal rhythym
 Prevent clot formation in left atrium 
 Cardioversion
 Antiarrhythmic drugs
 Oral anticoagulant (preferred) or antiplatelet agent