2010年美国心脏病协会.doc

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1、2010年美国心脏病协会/卒中协会卒中一级预防指南（全文见附件）推荐要点GuidelinesforthePrimaryPreventionofStroke.GenerallyNonmodifiableRiskFactorsAgeN/ASexN/ALowbirthweightN/ARace/ethnicityN/AGeneticfactorsRecommendations1.Obtainingafamilyhistorycanbeusefultohelpidentifypersonswhomaybeatincreasedriskofst

2、roke(ClassIIa;LevelofEvidenceA).2.Geneticscreeningofthegeneralpopulationforpreventionofafirststrokeisnotrecommended(ClassIII;LevelofEvidenceC).3.Referralforgeneticcounselingmaybeconsideredforpatientswithraregeneticcausesofstroke(ClassIIb;LevelofEvidenceC).4.Treatmentfor

3、certaingeneticconditionsthatpredisposetostroke(eg,Fabrydiseaseandenzymereplacementtherapy)mightbereasonablebuthasnotbeenshowntoreduceriskofstroke,anditseffectivenessisunknown(ClassIIb;LevelofEvidenceC).5.Screeningofpatientsatriskformyopathyinthesettingofstatinuseisnotre

4、commendedwhenconsideringinitiationofstatintherapyatthistime(ClassIII;LevelofEvidenceC).6.Noninvasivescreeningforunrupturedintracranialaneurysmsinpatientswith1relativewithSAHorintracranialaneurysmsisnotrecommended(ClassIII;LevelofEvidenceC).7.Noninvasivescreeningforunrup

5、turedintracranialaneurysmsinpatientswith>2first-degreerelativeswithSAHorintracranialaneurysmsmightbereasonable(ClassIIb;LevelofEvidenceC).8.UniversalscreeningforintracranialaneurysmsincarriersofmutationsforMendeliandisordersassociatedwithaneurysmisnotrecommended(ClassII

6、I;LevelofEvidenceC).9.NoninvasivescreeningforunrupturedintracranialaneurysmsinpatientswithADPKDand>1relativeswithADPKDandSAHorintracranialaneurysmmaybeconsidered(ClassIIb;LevelofEvidenceC).10.Noninvasivescreeningforunrupturedintracranialaneurysmsinpatientswithcervicalfi

7、bromusculardysplasiamaybeconsidered(ClassIIb;LevelofEvidenceC).11.DosingwithvitaminKantagonistsonthebasisofpharmacogeneticsisnotrecommendedatthistime(ClassIII;LevelofEvidenceC).Well-DocumentedandModifiableRiskFactorsHypertensionRecommendations1.InagreementwiththeJNC7rep

8、ort,regularBPscreeningandappropriatetreatment,includingbothlifestylemodificationandpharmacologicaltherapy,arer