[Drug therapy of stroke in the stroke unit. A race against time]

Ischemic stroke is usually a manifestation of arteriosclerosis in the elderly patient. The major risk factors are age and high blood pressure; prevention is particularly successful in hypertensives. All known antihypertensive agents can be applied, and ACE inhibitors and the lipid-lowering agents, in particular the statins are now well established. That said, under certain circumstances it might be of importance to pay greater attention to the other lipid fractions. It is currently estimated that only one-third of patients with a disturbance of lipid metabolism actually receives treatment. Results of treatment in the acute phase of apoplexy have been improved by the establishment of stroke units that provide the facilities for intensive and comprehensive management of stroke victims. Inhibitors of platelet aggregation, in particular aspirin, now have a permanent role in the acute and follow-up phase. For specific risk factors such as stenosis of the carotid artery or atrial flutter, special therapeutic guidelines apply.