For the past 2 decades, pharmacologic medical management to prevent first and recurrent ischemic stroke due to large and small artery atherothrombosis has focused on a 3-agent class approach: antithrombotic therapies, blood pressure– lowering medications, and low-density lipoprotein (LDL) cholesterol lowering with statins.1 However, in recent years randomized trials have demonstrated that several additional medical-pharmacologic strategies can confer additional protection. Because these advances have occurred incrementally and often with ischemic stroke prevention as just 1 component of general cardiovascular event prevention, they are not yet widely appreciated or used by general neurologists and vascular neurology clinicians. Increased awareness of these new agent classes and the evidence supporting them could help facilitate their routine addition to neurologic practice to attain the maximal possible reduction in stroke risk for patients.
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Lee M, Ovbiagele B, Saver JL. Intensive Medical Management to Prevent Large and Small Artery Atherothrombotic Stroke: Time to Expand the Horizon. JAMA. 2021;326(3):217–218. doi:10.1001/jama.2021.9917
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