Ataque cardiaco y accidente cerebrovascular: prevencion by Organizacion Panamericana de la Salud

By Organizacion Panamericana de la Salud

This booklet summarizes the facts for the effectiveness of interventions for secondary prevention of heart ailment (CHD) and cerebrovascular illness (CeVD). A remark at the facts for cardiovascular prevention in peripheral vascular affliction and diabetes is usually integrated. every one overview of proof is through a brief precis of scientific strategies for secondary prevention. A assessment of alternative issues influencing policy-makers within the implementation of secondary prevention thoughts together with well-being economics follows. eventually, the publication identifies components during which learn is required to enhance secondary prevention of CVD in low- and middle-income populations. This booklet is meant for practising physicians accountable for the care of sufferers with validated heart problems (CVD) - in particular CHD and CeVD - in low- and middle-income populations and nations. the purpose is to supply common assistance in regards to the effectiveness - or loss of effectiveness - of particular interventions, either pharmacological and non-pharmacological. moreover, the data may help quite a lot of overall healthiness execs fascinated with person and group care and may supply assistance to healthiness policy-makers in regards to the broader matters touching on implementation of interventions in low- and middle-income populations.

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Extra info for Ataque cardiaco y accidente cerebrovascular: prevencion

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Antagonistas del calcio Los análisis sistemáticos de los ensayos aleatorizados controlados sobre el tratamiento con antagonistas del calcio después de un IM no han mostrado que su uso brinde beneficio general alguno (102). Se observaron pruebas particularmente importantes de la ausencia de beneficios con la administración de dihidropiridinas. Es posible que el diltiazem y el verapamilo reduzcan el riesgo de episodios vasculares recurrentes en pacientes que, después de un IM, no presentan disfunción ventricular izquierda ni insuficiencia cardíaca, aunque esto no se ha determinado todavía con claridad.

Recomendaciones (véase el cuadro 4) Se debe aconsejar a todos los pacientes que adopten un régimen de alimentación que permita reducir el riesgo de enfermedad vascular recurrente, es decir, bajo consumo de sal, alto consumo de frutas y hortalizas, bajo consumo de grasa total (menos de 30% del total de calorías) y de grasa saturada (menos de 10% del total de calorías). 2 INTERVENCIONES FARMACOLÓGICAS Se han evaluado varios tratamientos farmacológicos para la prevención secundaria de la ECeV. Se pueden dividir en tres categorías.

Entre los pacientes con enfermedad vascular establecida, el riesgo de hemorragia es superado con creces por la reducción EFICACIA DE LAS INTERVENCIONES EN LA PREVENCIÓN SECUNDARIA DE LA ECV del riesgo de episodios vasculares recurrentes. Los pacientes con antecedentes de dispepsia o de úlcera péptica que necesiten tomar aspirina deben tratarse con dosis relativamente bajas (75 mg diarios) de aspirina con revestimiento entérico. OTROS TRATAMIENTOS ANTIPLAQUETARIOS: DIPIRIDAMOL Y TIENOPIRIDINA Dipiridamol Se ha demostrado que el dipiridamol reduce el riesgo de episodios vasculares recurrentes después de un ACV en grado similar al logrado con dosis mínimas de aspirina (50 mg diarios) (170).

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