Similar results were reported for total cholesterol .
Blood pressure reductions were noted but were non-significant when corrected for multimodal packages including enhanced pharmacotherapy compliance .
Conclusions There is currently insufficient high quality research to support lifestyle interventions post-stroke or TIA on mortality , CVD event rates and cardio-metabolic risk factor profiles .
Promising blood pressure reductions were noted in multimodal interventions which addressed lifestyle
Background and purpose Secondary prevention in ischaemic stroke and transient ischaemic attack ( TIA ) is dominated by pharmacological interventions with evidence for non-pharmacological interventions being less robust .
This systematic review and meta- analysis examines the impact of lifestyle interventions on secondary prevention in stroke or TIA .
Combining Multiple Approaches for the Secondary Prevention of Vascular Events After Stroke: A Quantitative Modeling Study
Background and Purpose — Numerous effective strategies for the secondary prevention of cardiovascular events in high-risk patients have now been established . We sought to calculate the cumulative benefit of combining multiple strategies for preventing recurrent events in patients with a history of ischemic stroke or transient ischemic attack . Methods — A comprehensive literature search was undertaken to identify meta-analyses of r and omized controlled trials reporting on the efficacy of secondary prevention strategies . The baseline incidence of vascular events was modeled from the Life Long After Cerebral Ischemia study . Strategies were combined on a multiplicative scale and cumulative risk reductions were computed over a 5-year interval . Results — The combination of 5 proven strategies applied to survivors of an initial stroke or transient ischemic attack — dietary modification , exercise , aspirin , a statin , and an antihypertensive agent — could result in a cumulative relative risk reduction of 80 % . Given a 5-year major cardiovascular event rate of 24 % , this translates to a number needed to treat of about 5 . Further gains would result from applying multimodality therapy over longer intervals and enriching the base strategy with dual antiplatelet therapy , high-dose statins , and more intensive blood pressure – lowering . Even more benefit would be present in high-risk subgroups with the addition , where appropriate , of carotid endarterectomy , moderate intensity oral anticoagulants , glycemic control , and smoking cessation . Conclusions — At least four-fifths of recurrent vascular events in patients with cerebrovascular disease might be prevented by application of a comprehensive , multifactorial approach
Similar results were reported for total cholesterol .
Blood pressure reductions were noted but were non-significant when corrected for multimodal packages including enhanced pharmacotherapy compliance .
Conclusions There is currently insufficient high quality research to support lifestyle interventions post-stroke or TIA on mortality , CVD event rates and cardio-metabolic risk factor profiles .
Promising blood pressure reductions were noted in multimodal interventions which addressed lifestyle
Background and purpose Secondary prevention in ischaemic stroke and transient ischaemic attack ( TIA ) is dominated by pharmacological interventions with evidence for non-pharmacological interventions being less robust .
This systematic review and meta- analysis examines the impact of lifestyle interventions on secondary prevention in stroke or TIA .