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Old 07-14-2011
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Neuro Best action to reduce stroke risk

A 50 y/o man presents to the physician for routine care. He has hypertension, hypercholesterolemia, and type 2 diabetes mellitus and smoked 1 ppd for the past 30 years. Meds include thiazide, atorvastatin and glipizide. There is family history of MI in the maternal grandfather at age 58. Physical reveals obese man who is 5'9'' and weighs 238 lbs. His bp is 155/81 mmHg, HR is 78/mn, respiratory rate is 14/mn and T is 36.8 C. What one action would most reduce the patient's stroke risk?

A. Blood glucose reduction
B. Blood pressure reduction
C. Serum cholesterol
D. Smoking cessation
E. Weight Loss
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Old 07-14-2011
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Default stop smoking!!!

d:smoking cessation??
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Old 07-14-2011
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blood pressure reduction?
smoking cessation leads to fastest risk reduction but i think BP is more crucial.
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Old 07-14-2011
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2 of the major risk factors for stroke are HTN as well as DM

I know for HTN the most important life style change is wt loss
At the same time WT loss is also the best lifestyle change of a diabetic

so since it really helps decerease both conditions significantly im gonna choose

e ) wt loss
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Old 07-14-2011
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Quote:
Originally Posted by docnas View Post
2 of the major risk factors for stroke are HTN as well as DM

I know for HTN the most important life style change is wt loss
At the same time WT loss is also the best lifestyle change of a diabetic

so since it really helps decerease both conditions significantly im gonna choose

e ) wt loss
isn't it better to choose HTN directly rather than a factor that contributes to reduction of HTN over time? HTN can be controlled with weight loss but we can also use medications whereas weight loss is a long process and not all pt's are compliant.
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Old 07-14-2011
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True that is also a way to think of it but i focused on the actual question "
What one action would action would most reduce the patient's stroke risk?"

ie not what is easier also because diabetes is a high risk factor and the wt loss will decrease it along with the HTN ,i think it just adds up to it being technically the best/ most efficient way

now the question if it is the easiest/ most commonly applied well i cant say about that have to see what aksyonez says about it.
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Old 07-14-2011
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I am thinking btween wt loss and bp reduction. Obesity is interlinked to all other factors but wt reduction will take time and by then he may have stroke episode ...moreever it reduces stroke risk for long term in long term....compairing with BP, it can be reduced in short term and free patient from stroke risk....and more over we see majority of stroke in hypertensive compaired to obese so my choice is BP reduction.....
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Old 07-14-2011
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B. Blood pressure reduction.
__________________
"A ship in the harbor is safe,but that is not what ships were built for."-Donald Kendall.
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B. Blood pressure reduction
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Old 07-14-2011
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So its preety much narrowed down between wt loss and BP, im still feeling wt loss is the better answer for its being benificial across the whole spectrum of problems hes having .

I guess we will have to wait for the OP to post the answer ( hopefully with an explanation)
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Old 07-15-2011
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HTN is most common risk factor and DM is the worst one..

I would go with b. Blood Pressure reduction
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Old 07-15-2011
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The correct answer is B. Hypertension is the most controllable risk factor for stroke, and the stroke's risk attributable to this patient's blood pressure is larger than any other factor.
reducing serum cholesterol does impact the stroke risk but not have a greater impact on stroke risk than hypertension.
Stroke prevention studies have implicated hypertension as the general contributing risk factor to stroke.
Smoking cessation would improve the patient's overall health, longevity and should be encouraged but cerebrovascualr accidents are multifactorial but hypertension has have largest effect on stroke risk.
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Internal-Medicine-, Neurology-, Preventive-Medicine-, Step-2-Questions

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