Nicht medikamentöse Prophylaxe des Schlaganfalls

Abstract

Stroke is still the leading cause of long-term major disability in the developed countries, although several improvements have been achieved in acute stroke therapy (e.g., thrombolysis, stroke-unit treatment, optimised early rehabilitation strategies). Therefore, primary prevention as well as an effective secondary prevention - guided by the etiology and risk factors of stroke -is of particular importance to reduce stroke morbidity. In addition to medical prevention strategies (antihypertensives, thrombocyte inhibitors, anticoagulation in atrial fibrillation, statins, etc.), several, including evidenced-based, non-medical options for the primary and secondary prevention of stroke are available. This review summarises the current status of non-medical prevention measures for stroke. In the first part we focus on the importance of obesity, smoking, alcohol, nutrition, vitamin supplementation, physical activity, sleep-apnea syndrome, psychosocial stress and hormone therapy. In the second part we discuss the indications and efficacy of an invasive treatment of symptomatic and asymptomatic carotid stenosis.