| People
who have had mini and ischemic strokes should have their blood pressure and other
risk factors checked periodically to prevent the silent threat of heart disease.
Up to 40 percent
of patients with mini-strokes, also known as transient ischemic
strokes, and ischemic strokes have silent heart disease in which
sufferers exhibit no symptoms.
The
recommendation for such check-ups was contained in an American Heart Association/American
Stroke Association scientific statement in the September 9 issue of the journal
Circulation.
The panel
of researchers who wrote the statement found a link between silent
heart disease and mini-strokes and ischemic strokes originating
in large vessels to the brain.
"Compared
to patients with strokes caused by blockage in small vessels in the brain, patients
with transient ischemic strokes or large-vessel strokes have a higher likelihood
of also having coronary artery disease, whether or not they have a clear history
of heart disease," said lead
author Dr. Robert Adams,a
professor of neurology at the Medical College of Georgia. Adams
and his colleagues recommend that doctors use the Framingham risk estimation tool
that calculates risk
factors, such as age, gender, cholesterol, blood pressure, smoking and diabetes
to determine a person's level of risk for heart disease within 10 years. A patient
whose risk is 20 percent or higher should be considered for further noninvasive
testing to detect silentheart disease.
The
authors don't recommend routine testing for all stroke patients, and they say
testing doesn't need to occur while patients are hospitalized immediately after
stroke. However, they noted that all people with stroke should undergo a comprehensive
assessment and doctors should encourage them to reduce their risk factors for
heart disease.
Other
sources: American Heart Association |