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January 22, 2019; 92 (4) Editorial

Stroke prevention

How low can you go?

Steven K. Feske, Cheryl Bushnell
First published December 26, 2018, DOI: https://doi.org/10.1212/WNL.0000000000006802
Steven K. Feske
From the Department of Neurology (S.K.F.), Harvard Medical School; Neurology Department (S.K.F.), Stroke Division, Brigham and Women's Hospital, Boston, MA; and Department of Neurology (C.B.), Stroke Division, Wake Forest Baptist Health, Winston-Salem, NC.
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Cheryl Bushnell
From the Department of Neurology (S.K.F.), Harvard Medical School; Neurology Department (S.K.F.), Stroke Division, Brigham and Women's Hospital, Boston, MA; and Department of Neurology (C.B.), Stroke Division, Wake Forest Baptist Health, Winston-Salem, NC.
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Stroke prevention
How low can you go?
Steven K. Feske, Cheryl Bushnell
Neurology Jan 2019, 92 (4) 159-160; DOI: 10.1212/WNL.0000000000006802

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Stroke is the fourth-leading cause of death in the United States and a leading cause of long-term disability.1,2 However, the rate of stroke has fallen dramatically in high-income countries over the past 40 years.3 This drop is attributed to better preventive care that addresses stroke risk factors, including better control of hypertension, increased use of statins, and the successful societal campaign to reduce smoking. Although uncommon in young patients, stroke risk increases during pregnancy and the postpartum period, and stroke is a leading cause of long-term disability in young women, both physical disability and depression. Preeclampsia-eclampsia (PEE) underlies a large proportion of strokes associated with pregnancy.4 PEE also correlates with a higher lifelong risk of cardiovascular disease, including stroke.5,6 It remains unclear whether PEE simply identifies those at high risk or causes long-lasting multiorgan vascular effects that confer later vulnerability.7 The identification of PEE as a risk factor for future stroke raises important questions of risk stratification and preventive therapy.

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  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

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  • © 2018 American Academy of Neurology
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