Definition of Best Medical Treatment in Asymptomatic and Symptomatic Carotid Artery Stenosis.

Kosmas I Paraskevas, Dimitri P Mikhailidis, Frank J Veith, J David Spence

Journal: Angiology 2016;67(5):411-9

PMID: 26721504

Abstract

Implementation of best medical treatment (BMT) is the cornerstone of the management of patients with either asymptomatic or symptomatic carotid artery stenosis. We review the literature to define the components of BMT. Smoking cessation, maintaining a healthy body weight, moderate exercise, and a Mediterranean diet are essential lifestyle measures. Moderate alcohol consumption may also be beneficial but recommending it to patients may be hazardous if they consume too much. The importance of lifestyle measures is largely underestimated by both physicians and patients. Blood pressure and diabetes control, antiplatelet agents, and lipid-lowering treatment with statins/ezetimibe comprise the pharmacological components of BMT. Initiation of an intensive regimen of BMT is a sine qua non for patients with carotid artery stenosis whether or not they are offered or undergo an invasive revascularization procedure.

Address: Department of Vascular Surgery, Southampton University Hospital, Southampton, United Kingdom [email protected].; Department of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital Campus, University College London Medical School, University College London (UCL), London, United Kingdom.; Division of Vascular Surgery, New York University Langone Medical Center, New York, NY, USA Division of Vascular Surgery, The Cleveland Clinic, Cleveland, OH, USA.; Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Ontario, Canada.

DOI: 10.1177/0003319715624526

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MeSH Terms: Asymptomatic Diseases, Carotid Stenosis, Endarterectomy, Carotid, Humans, Life Style, Platelet Aggregation Inhibitors, Stroke