Stroke therapies in Asian populations
Section snippets
Background
Thirty years ago, there were no interventions for patients with acute stroke or secondary prevention which were of proven benefit. Fortunately, that has changed, and there are now three acute stroke interventions for which there exists level 1 evidence of efficacy and five secondary prevention strategies.
It is often suggested that there may be racial differences in response to various forms of therapy in vascular and other diseases. This is an extension of the observation that different
Acute therapies
There is level 1 evidence that the use of intravenous tissue plasminogen activator (tPA) given within 3 h of acute ischaemic stroke, oral aspirin within 48 h and management within a Stroke Care Unit (SCU) improves outcomes. The administration of neuroprotective therapies has been the subject of numerous clinical trials, but none have proven to be effective. For both intravenous tPA and aspirin, there is additional evidence that these approaches may be effective in Asian populations.
Secondary prevention
Five secondary prevention strategies have now been proven to be of benefit based on level 1 evidence. Because hypertension is the most powerful risk factor for stroke apart from increasing age, it is of particular interest in Asian populations.
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