12B. Primary prevention of stroke

The primary prevention of stroke is similar to that of all cardiovascular disease. Many major risk factors for CVD are modifiable. 90% of stroke burden globally is due to modifiable risk factors.

CHA2DS2-VASC score

This score is used to determine whether patients with atrial fibrillation should receive anticoagulants or not. The score is like this:

  • Congestive heart failure – 1 point
  • Hypertension – 1 point
  • Age > 75 years – 2 points
  • Diabetes mellitus – 1 point
  • Stroke, TIA, or thromboembolism – 2 points
  • Vascular disease (CAD, PAD, etc.) – 1 point
  • Age 65 – 74 years – 1 point
  • Sex Category: female – 1 point

Anticoagulation is indicated if the score is 2 or more in men or 3 or more in women. The recommended anticoagulant is a DOAC.

Other primary preventions

  • Healthy diet – increase intake of
    • Fruits and vegetables
    • Fibre
    • Foods with low glycaemic index and low glycaemic load
    • Monounsaturated fat rather than trans or saturated fat
    • Omega-3 fatty acids from foods
  • Smoking cessation
  • Hypertension – treat
  • Dyslipidaemia – treat
  • Increase physical activity
    • Moderate intensity exercise for 150 minutes/week OR:
    • Vigorous intensity exercise for 75 minutes/week
  • Weight loss – in cases of overweight or obesity
  • Treatment of type 2 diabetes

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12A. Encephalitis

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13A. Ischias syndrome and cervicobrachialgia (symptoms, warning signs)

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