Key result
Improved medical management of carotid stenosis requires aggressive risk factor reduction, particularly antihyperlipidemic therapy.
Why the study?
Significant areas of risk stratification and management of carotid stenosis remain to be improved despite decreased stroke rates in North America.
This review highlights the evolving role of aggressive medical management and risk factor reduction in treating carotid stenosis, complementing traditional surgical approaches.
Stroke risk stratification needs refinement despite declining rates; leaves open optimal integration of hypertension and carotid stenosis management.
Stroke is a leading cause of morbidity and mortality in the developed world. Although the rates of stroke have decreased in North America, there are significant areas of risk stratification and management that can be improved. Hypertension is the most significant and perhaps most modifiable risk factor for stroke. Carotid atherosclerotic disease is associated with 15% of ischemic strokes. Although carotid endarterectomy (CEA) remains a recommendation for significant symptomatic carotid stenosis, controversy continues in the management of asymptomatic and recurrent carotid stenosis. Medical management options and effectiveness has significantly improved since the early CEA trials were published. Optimal medical management now must incorporate aggressive risk factor reduction measures, particularly with antihyperlipidemic therapy. Improved understanding of the natural history of carotid atherosclerosis is necessary to improve the application of management strategies.
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Robert C. Shields (2010) conducted a review in Carotid stenosis. Medical management was evaluated. Medical management of carotid stenosis has significantly improved and must incorporate aggressive risk factor reduction measures, particularly antihyperlipidemic therapy.
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