Drugs used in the prevention of cerebrovascular diseases and their side effects

1. Big picture

Drug prevention of cerebrovascular disease means preventing first stroke or recurrent stroke/TIA by treating the major modifiable mechanisms:

1. Thrombosis on atherosclerotic plaques → antiplatelet drugs
2. Cardioembolism, especially atrial fibrillation → anticoagulants
3. Atherosclerosis and plaque instability → statins
4. Hypertension → antihypertensive drugs
5. Diabetes, smoking, obesity, lifestyle risks → risk-factor control

The key exam sentence:

In non-cardioembolic ischemic stroke/TIA, use antiplatelet therapy; in cardioembolic stroke, especially atrial fibrillation, use anticoagulation; in most ischemic stroke patients, add statin a