Life-saving advice for doctors and patients--both those at risk of a first stroke and those who have already had a mini-stroke, the #1 risk factor facing survivors

This book is written in the hope of preventing strokes, based on advice Dr. Spence has given to the more than 16,000 at-risk patients he has seen. It is divided into two sections -- "What Your Doctor Can Do" and "What You Can Do."

Quitting smoking, following a Mediterranean diet, taking appropriate drugs to reduce blood pressure, cholesterol, and blood clotting, and appropriate surgery for severely narrowed arteries in the neck can reduce stroke by as much as 75 percent in high-risk people.

* Especially among African Americans, but in anyone with blood pressure that is difficult to control, two simple blood tests (measuring renin and aldosterone) make all the difference to successful treatment.

* A Mediterranean diet will reduce stroke by nearly half in high-risk people. Dr. Spence provides a collection of gourmet "anti-stroke" recipes that he prepares for himself.
* Vitamin treatment with folic acid, B6, and B12 may prevent stroke by lowering levels of a new risk factor called homocysteine.
* Advanced imaging methods are improving management of arteries by providing feedback on the effectiveness of therapy.
* Transcranial Doppler embolus detection can identify, among patients with narrowing of the carotid arteries who do not yet have symptoms, the ones who are likely to benefit from surgery or stenting.

This approach is the powerful medicine for stroke prevention that patients and their physicians need and will learn from this book.

About the Author

J. David Spence, MD, one of the world's leading experts in stroke prevention, is Professor of Neurology and Clinical Pharmacology at the University of Western Ontario and Director of the Stroke Prevention and Atherosclerosis Research Centre at the Robarts Research Institute. He pioneered ultrasound measurement of carotid plaque, and was one of the researchers on the team that discovered the dangerous drug interactions with grapefruit.

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