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Nuevas pruebas para la prevención del accidente cerebrovascular: revisión científica

Sharon E Straus¹, Sumit R Majumdar, Finlay A McAlister

¹Division of General Internal Medicine, Department of Medicine, University Health Network, Toronto General Hospital, 200 Elizabeth St, ENG 248, Toronto, Ontario, Canada M5G 2C4. sstraus@mtsinai.on.ca

|September 18, 2002

Resumen

Existen estrategias efectivas de prevención del ictus tanto para la prevención primaria como para la secundaria. La evidencia apoya el manejo de la presión arterial y la hiperlipidemia, además de terapias específicas para pacientes con fibrilación auricular e infarto de miocardio.

Área de la Ciencia:

Neurología Neurología.
Medicina Cardiovascular La medicina cardiovascular es una especialidad de la salud.
Salud Pública La salud pública.

Sus antecedentes:

El accidente cerebrovascular sigue siendo una de las principales causas de muerte y discapacidad.
La aplicación actual de la prevención del accidente cerebrovascular basada en la evidencia es inconsistente.

Objetivo del estudio:

Revisar sistemáticamente la evidencia reciente y de alta calidad para la prevención primaria y secundaria del ictus.
Consolidar los hallazgos para mejorar la práctica clínica.

Principales métodos:

Búsqueda exhaustiva de la literatura de las principales bases de datos médicas (MEDLINE, Cochrane Library, ACP Journal Club) desde 1998 hasta el año 2001.
Escaneo de referencias y consulta de expertos para asegurar la inclusión de todos los estudios relevantes.
Evaluación rigurosa de la calidad de los artículos identificados utilizando niveles establecidos de evidencia.

Principales resultados:

Prevención primaria: las estrategias efectivas incluyen la reducción de la presión arterial, el tratamiento de la hiperlipidemia, la terapia antitrombótica para la fibrilación auricular y la terapia antiplaquetaria después del infarto de miocardio.
Prevención secundaria: las estrategias efectivas incluyen el manejo de la hipertensión y la hiperlipidemia, la terapia antitrombótica para la fibrilación auricular, la terapia antiplaquetaria y la endarterectomía carotídea para la estenosis severa.

Conclusiones:

Un cuerpo sustancial de evidencia apoya numerosas estrategias de prevención primaria y secundaria del ictus.
La prevención del accidente cerebrovascular es un problema crítico de salud pública que requiere la aplicación consistente de intervenciones probadas.

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