Secondary prevention

 

Recommendations 5.6.1

A. All patients who have had an ischaemic stroke or TIA should be offered treatment with a statin drug unless contraindicated.  Treatment:

• Should be initiated using a drug with low acquisition cost such as simvastatin 40mg daily
• Should be intensified if a total cholesterol of <4.0 mmol/L or an LDL cholesterol of <2.0 mmol/L is not attained with initial therapy.

B. All patients who have had an ischaemic stroke or TIA should receive advice on lifestyle factors that may modify lipid levels, including diet, physical activity, weight, alcohol and smoking (see section 5.3)

C. Treatment with statin therapy should be avoided and only used with caution, if required for other indications, in individuals with a recent primary intracerebral haemorrhage

Sources 5.6.2

A. National Institute for Health and Clinical Excellence 2008a
B. See sources 5.3.2
C. Goldstein et al. 2008; Vergouwen et al. 2008; consensus