Cerebral Atherosclerosis: Drug Therapy

Therapeutic target

• Optimal control of: Diabetes mellitus, arterial hypertension (high blood pressure), and hyperlipidemia (dyslipidemia) (target LDL < 100 mg/dl).

Therapy recommendations

• See under diabetes mellitus, arterial hypertension, and the corresponding forms of hyperlipidemia.
• Anticoagulation (inhibition of blood clotting):
  • Individuals with atrial fibrillation (AF) and concomitant risk factors should be effectively orally anticoagulated (INR 2.0 – 3.0)
  • Individuals with atrial fibrillation without concomitant risk factors should be treated with acetylsalicylic acid (ASA; 100-300 mg/d)
  • Primary prevention of apoplexy by acetylsalicylic acid (ASA) has very limited efficacy in men; in women with vascular (“vascular-related”) risk factors, risk reduction is rather small.
  • Taking ASA around 10 p.m. leads to more pronounced platelet inhibition in the cardiovascularly critical morning hours
• See also under “Further Therapy.”