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The 2021 7th Annual Conference of Chinese Stroke Society and Tiantan International Cerebrovascular Disease Conference (CSA & TISC 2021) will be held in Beijing National Convention Center from July 9th to 11th, 2021
.
In the long-term management of ischemic stroke risk factors of this conference, Professor He Li from West China Hospital of Sichuan University gave a special report on the management of ischemic stroke blood lipids and progress.
After the meeting, Yimaitong was fortunate to give He Li The professor conducted an exclusive interview, and the article is organized as follows
.
The author of this article: Yimaitong Tiantan will report the report group Yimaitong compiled reports, please do not reprint without authorization
.
Professor Li He, Deputy Director, Department of Neurology, West China Hospital of Sichuan University, West China Hospital, Sichuan University, and PhD supervisor Member of the Standing Committee of the Chinese Preventive Medicine Association for Stroke Prevention and Control Committee Member of the Head and Facial Pain Group of the Chinese Medical Association Pain Branch, Member of the Pain and Sensory Disorders Group of the Neurology Branch of the Chinese Medical Doctor Association: High cholesterol is one of the risk factors for stroke, especially It is low-density lipoprotein cholesterol, so I would like to ask the teacher to talk about the control standards of cholesterol in the secondary prevention of ischemic stroke? Professor He Li high cholesterol is a clear risk factor for stroke, and it is the main risk factor, but the main target is low-density lipoprotein cholesterol
.
With the continuous deepening of research, the current research on low-density lipoprotein cholesterol has been very mature
.
The standard of cholesterol control for secondary prevention of ischemic stroke has always followed the "5018" principle
.
"50" means to reduce the cholesterol level from the original level by 50%, or reach the 1.
8mmol level
.
Although in clinical practice, including some studies that our team is also doing, the dosage of drugs may not meet this gold standard
.
From a single-center study, even if it does not meet the standards, it still has a certain effect
.
However, due to the lack of sufficient evidence at present, in actual clinical practice, treatment should be achieved according to the standards of the guidelines
.
Yimaitong: For patients with low-density lipoprotein cholesterol levels, how much is appropriate? Do I need to continue treatment after falling to the normal range? Professor He Li has relatively low standards for secondary prevention.
Generally speaking, patients with a level of less than 1.
8mmol account for a small number of patients
.
Moreover, the low level of LDL cholesterol is not a major problem affecting the health of patients
.
If the patient's low-density lipoprotein cholesterol level is less than 1mmol, the patient will be more nervous.
This situation may reduce the dosage of the drug, but there is currently no sufficient evidence
.
From the perspective of clinical practice, in principle, medication should be used, even if it drops to a normal range, it should be treated, because this is a long-term preventive process, and lipid-lowering drugs can not only reduce the level of low-density lipoprotein cholesterol, it It also protects blood vessels and reduces inflammatory reactions, so as long as there are no side effects, stick to it
.
If the low-density lipoprotein cholesterol level is less than 1.
5mmol, or even less than 1mmol, the dosage can be reduced at this time
.
Yimaitong: For patients with abnormal liver and kidney function, what points should be paid attention to when managing blood lipids? Professor He Li's lipid-lowering drugs have relatively little effect on renal function, and renal damage is not the main side effect, so when the renal damage is not serious, it can be used under close monitoring
.
Special attention should be paid to liver damage, and a small number of patients do cause liver damage
.
However, according to the standard of the guidelines, it is necessary to exceed the normal liver function value at least three times before there is an indication for discontinuation
.
If it is less than three times, it can be used under close monitoring of liver function, or it can be treated by halving the dose appropriately
.
In addition, pay attention to whether the patient uses other drugs, because often in the process of stroke treatment, many patients like to use other drugs, such as health care drugs.
At this time, it is necessary to closely monitor liver and kidney function and adjust the dosage according to the guidelines
.
If liver and kidney dysfunction has occurred, the drug should still be discontinued.
After the drug is stopped, other types of lipid-lowering drugs can be selected for treatment according to the specific situation, or be observed for a period of time
.
As long as there are no side effects, the medication must be adhered to
.
Lock to the medlive-neurology channel (medlive-neurology) to view the latest information of CSA & TISC 2021! Long press the QR code to follow the CSA & TISC 2021 special report ☟☟☟ You can also click "Read the original text" to view More CSA & TISC 2021 topics related content!
.
In the long-term management of ischemic stroke risk factors of this conference, Professor He Li from West China Hospital of Sichuan University gave a special report on the management of ischemic stroke blood lipids and progress.
After the meeting, Yimaitong was fortunate to give He Li The professor conducted an exclusive interview, and the article is organized as follows
.
The author of this article: Yimaitong Tiantan will report the report group Yimaitong compiled reports, please do not reprint without authorization
.
Professor Li He, Deputy Director, Department of Neurology, West China Hospital of Sichuan University, West China Hospital, Sichuan University, and PhD supervisor Member of the Standing Committee of the Chinese Preventive Medicine Association for Stroke Prevention and Control Committee Member of the Head and Facial Pain Group of the Chinese Medical Association Pain Branch, Member of the Pain and Sensory Disorders Group of the Neurology Branch of the Chinese Medical Doctor Association: High cholesterol is one of the risk factors for stroke, especially It is low-density lipoprotein cholesterol, so I would like to ask the teacher to talk about the control standards of cholesterol in the secondary prevention of ischemic stroke? Professor He Li high cholesterol is a clear risk factor for stroke, and it is the main risk factor, but the main target is low-density lipoprotein cholesterol
.
With the continuous deepening of research, the current research on low-density lipoprotein cholesterol has been very mature
.
The standard of cholesterol control for secondary prevention of ischemic stroke has always followed the "5018" principle
.
"50" means to reduce the cholesterol level from the original level by 50%, or reach the 1.
8mmol level
.
Although in clinical practice, including some studies that our team is also doing, the dosage of drugs may not meet this gold standard
.
From a single-center study, even if it does not meet the standards, it still has a certain effect
.
However, due to the lack of sufficient evidence at present, in actual clinical practice, treatment should be achieved according to the standards of the guidelines
.
Yimaitong: For patients with low-density lipoprotein cholesterol levels, how much is appropriate? Do I need to continue treatment after falling to the normal range? Professor He Li has relatively low standards for secondary prevention.
Generally speaking, patients with a level of less than 1.
8mmol account for a small number of patients
.
Moreover, the low level of LDL cholesterol is not a major problem affecting the health of patients
.
If the patient's low-density lipoprotein cholesterol level is less than 1mmol, the patient will be more nervous.
This situation may reduce the dosage of the drug, but there is currently no sufficient evidence
.
From the perspective of clinical practice, in principle, medication should be used, even if it drops to a normal range, it should be treated, because this is a long-term preventive process, and lipid-lowering drugs can not only reduce the level of low-density lipoprotein cholesterol, it It also protects blood vessels and reduces inflammatory reactions, so as long as there are no side effects, stick to it
.
If the low-density lipoprotein cholesterol level is less than 1.
5mmol, or even less than 1mmol, the dosage can be reduced at this time
.
Yimaitong: For patients with abnormal liver and kidney function, what points should be paid attention to when managing blood lipids? Professor He Li's lipid-lowering drugs have relatively little effect on renal function, and renal damage is not the main side effect, so when the renal damage is not serious, it can be used under close monitoring
.
Special attention should be paid to liver damage, and a small number of patients do cause liver damage
.
However, according to the standard of the guidelines, it is necessary to exceed the normal liver function value at least three times before there is an indication for discontinuation
.
If it is less than three times, it can be used under close monitoring of liver function, or it can be treated by halving the dose appropriately
.
In addition, pay attention to whether the patient uses other drugs, because often in the process of stroke treatment, many patients like to use other drugs, such as health care drugs.
At this time, it is necessary to closely monitor liver and kidney function and adjust the dosage according to the guidelines
.
If liver and kidney dysfunction has occurred, the drug should still be discontinued.
After the drug is stopped, other types of lipid-lowering drugs can be selected for treatment according to the specific situation, or be observed for a period of time
.
As long as there are no side effects, the medication must be adhered to
.
Lock to the medlive-neurology channel (medlive-neurology) to view the latest information of CSA & TISC 2021! Long press the QR code to follow the CSA & TISC 2021 special report ☟☟☟ You can also click "Read the original text" to view More CSA & TISC 2021 topics related content!
