Prevention of Stroke

About 10-15% of patients with ischaemic stroke may develop another stroke within 1 year of their TIA / stroke. It is therefore important that the underlying pathophysiological cause of stroke be identified timely and treated appropriately to minimise the risk of another stroke. There are a number of ways that a doctor can help you prevent another stroke after your first stroke:

A. Medications to Control Risk Factors:

Medications given to prevent another stroke often includes:

1. Antiplatelet agents (for ischaemic stroke), e.g. aspirin, clopidogrel (Plavix), persantin, Aggrenox, cilostazol and Ticagrelor
    

2. Anticoagulants (for ischaemic stroke), e.g. warfarin or ‘NOACs’ such as dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis) and edoxaban (Lixiana)
    

3. Statins, e.g. simvastatin (Zocor), atorvastatin (Lipitor) and rosuvastatin (Crestor). Note that these agents, besides lowering the cholesterol, also has beneficial effects in protecting arteries and preventing further blockages within the arteries
    

4. Blood pressure lowering tablets, the usual blood pressure target after your stroke is <130/80mmHg unless specified by your doctor
    

5. Medications to treat diabetes

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B. Surgical Treatment

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In a selected group of patients with severe blockage of a large artery (usually in the neck region) occurring on the same side of brain being affected, a surgical operation (carotid endarterectomy or stenting) for clearing up the blockage can be considered.