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Evaluation needed to gauge silent threat lurking within stroke patients

es to determine a person's level of risk for heart disease within 10 years. Regardless of stroke subtype, a patient whose risk is 20 percent or higher should be considered for further noninvasive testing to detect "silent" heart disease.

The authors recommend that treatment for silent heart disease should be individualized, "and you can't do that until you see the severity of the heart disease after proactive testing," Adams said.

The authors don't recommend routine testing for all stroke patients, and they say testing doesn't need to occur while patients are hospitalized immediately after stroke. However, all people with stroke should undergo a comprehensive assessment and doctors should encourage them to reduce their risk factors for heart disease, via smoking cessation, diet, etc.

"Of course, all stroke patients should be evaluated for the cause of the stroke and appropriate secondary prevention treatments should be instituted as soon as possible," he added.

Further research is needed on asymptomatic patients to determine the risk of heart disease, as well as the cost effectiveness of additional testing and treatment as recommended by this panel, he said.

"Stroke survivors should understand that they need to be concerned about preventing another stroke, but also preventing heart disease, even if they don't have recognized heart disease symptoms," Adams said.

Co-authors are Marc I. Chimowitz, M.D.; Joseph S. Alpert, M.D.; Issam A. Awad, M.D.; Manuel D. Cerqueria, M.D.; Pierre Fayad, M.D.; and Kathryn A. Taubert, Ph.D.


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Contact: Carole Bullock
carole.bullock@heart.org
214-706-1279
American Heart Association
8-Sep-2003


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