脳卒中の予防のための新しい証拠:科学的なレビュー
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
JAMA
|September 18, 2002
まとめ
効果的な脳卒中予防戦略は,プライマリ予防とセカンダリー予防の両方に存在します. 証拠は,血圧と高脂血症の管理,心房細動と心筋梗塞患者の特定の治療法を支持しています.
科学分野:
- 神経学 神経学とは
- 心血管医学 心血管医学
- 公衆衛生は公衆衛生である.
背景:
- 脳卒中は依然として死亡と障害の主な原因である.
- 証拠に基づいた脳卒中予防の現在の適用は矛盾しています.
研究 の 目的:
- 主要および次要脳卒中予防のための最新の高品質の証拠を体系的にレビューする.
- 改善された臨床実践のための発見を統合する.
主な方法:
- 1998年から2001年にかけての主要な医療データベース (MEDLINE,コクラン図書館,ACPジャーナルクラブ) の包括的な文献検索.
- 参考文献をスキャンし,専門家との協議を行い,関連するすべての研究が含まれるようにします.
- 確立されたレベルの証拠を用いて,特定された製品の厳格な品質評価.
主要な成果:
- 主要予防: 効果的な戦略には,血圧低下,高脂血症治療,心房細動に対する抗血栓治療,心筋梗塞後の抗血小板治療が含まれます.
- 2次予防:効果的な戦略には,高血圧と高脂血症の管理,心房細動に対する抗血栓療法,抗血小板療法,重度の狭窄症に対する大動脈末関節切除術が含まれます.
結論:
- 大量の証拠が,多数のプライマリおよびセカンダリー脳卒中予防戦略を支持しています.
- 脳卒中予防は,実証済みの介入の一貫した適用を必要とする重要な公衆衛生問題である.
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