Hypercholesterolemia: Diener HC

Leys D, Kwiecinski H, Bogousslavsky J, Bath P, Brainin M, Diener HC, Kaste M, Sivenius J, Hennerici MG, Hacke W, Anonymous00185, Anonymous00186. · No affiliation provided · Cerebrovasc Dis. · Pubmed #14707404 No free full text.

This publication has no abstract.

Weber R, Diener HC, Grond M. · Klinik für Neurologie, Universitätsklinikum Essen, Universität Duisburg-Essen. · Nervenarzt. · Pubmed #17846734 No free full text.

Abstract: Secondary prevention including lifestyle modulation and medical interventions remain the basic principle in our therapeutic challenge to reduce the risk of recurrent subsequent ischemic stroke. The substantial number of randomized clinical trials published in the past 2 years was broadened our evidence-based therapeutic armament in the field of secondary prevention of ischemic stroke. An update of current knowledge in secondary stroke prevention is presented in this review on the basis of the 2007 revised guidelines of the German Neurological Society and the German Stroke Society. Special emphasis is given to medical and nonmedical modulation of cardiovascular risk factors (treatment of hypertension, hypercholesterolemia, and diabetes mellitus), prophylactic vitamin supplementation, and the use of platelet inhibitors and treatment of symptomatic intracranial stenosis.

Döser S, März W, Reinecke MF, Ringleb P, Schultz A, Schwandt P, Becker HJ, Bönner G, Buerke M, Diener HC, Gohlke H, Keil U, Ringelstein EB, Steinmetz A, Gladisch R, Wehling M. · IV. Medizinische Klinik, Fakultät für Klinische Medizin Mannheim, Ruprecht-Karls-Universität Heidelberg. · Internist (Berl). · Pubmed #15340698 No free full text.

Abstract: Elderly patients are significantly less likely to receive statins than younger patients possibly because of doubts regarding compliance or concerns regarding the increased likelihood of adverse events and drug interactions. Poor compliance can be expected especially in patients suffering from dementia or depression as well as those whose stage of cardiovascular disease exhibits few symptoms. On the other hand, the clinical significance of CHD events is high in the elderly, and 80% of coronary deaths occur in patients aged over 65 years. The average statistical life expectancy of elderly and old patients is often underestimated. The HPS and PROSPER studies showed that statins reduce mortality and morbidity even in very elderly individuals with a high global cardiovascular risk and/or CAD. Patients up to the age of 79 years should be treated according to the same guidelines as younger patients. Statin therapy should only be considered for patients aged 80 years and older who are at a very high risk for cardiovascular events.

Grau AJ, Weimar C, Buggle F, Heinrich A, Goertler M, Neumaier S, Glahn J, Brandt T, Hacke W, Diener HC. · Department of Neurology, University of Heidelberg, Heidelberg, Germany. · Stroke. · Pubmed #11692017 links to  free full text

Abstract: BACKGROUND AND PURPOSE: Data on risk factors for etiologic subtypes of ischemic stroke are still scant. The aim of this study was to characterize stroke subtypes regarding risk factor profile, outcome, and current treatment strategies. METHODS: We analyzed data from 5017 patients with acute ischemic stroke (42.4% women, aged 65.9+/-14.1 years) who were enrolled in a large multicenter hospital-based stroke data bank. Standardized data assessment and stroke subtype classification were used by all centers. RESULTS: Sex and age distribution, major risk factors and comorbidities, recurrent stroke, treatment strategies, and outcome were all unevenly distributed among stroke subtypes (P<0.001, respectively). Cardioembolism, the most frequent etiology of stroke (25.6%), was particularly common in the elderly (those aged >70 years) and associated with an adverse outcome, a low rate of early stroke recurrence, and frequent use of thrombolytic therapy and intravenous anticoagulation. Large-artery atherosclerosis (20.9%), the most common cause of stroke in middle-aged patients (those aged 45 to 70 years), showed the highest male preponderance, highest rate of early stroke recurrence, and highest prevalence of previous transient ischemic attack, current smoking, and daily alcohol consumption among all subtypes. The highest prevalence of hypertension, diabetes mellitus, hypercholesterolemia, and obesity was found in small-vessel disease (20.5%), which, in turn, was associated with the lowest stroke severity and mortality. CONCLUSIONS: Our results foster the concept of ischemic stroke as a polyetiologic disease with marked differences between subtypes regarding risk factors and outcome. Therefore, studies involving risk factors of ischemic stroke should differentiate between etiologic stroke subtypes.