Evidence
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Lowering blood pressure reduces the risk of heart disease, stroke and death

This meta-analysis showed that a 10 mm Hg reduction of systolic blood pressure reduced the risk of major cardiovascular disease events by 20%, coronary heart disease by 17%, stroke by 27%, heart failure by 28%, and death from all causes by 13%. This study strongly supports offering drug treatments to reduce systolic blood pressure levels ...

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Evidence is growing that early mechanical removal of clots from blocked brain arteries may improve recovery after stroke

Restoring blood flow to the brain within a few hours of having a stroke improves a person’s chances of recovery. Early use of drugs to dissolve clots (thrombolysis) has been the mainstay of management in recent years and there has also been rapid development of devices to remove clots. Using evidence from trials published in ...

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Intermittent pressure on the legs helps prevent leg clots in immobile people after stroke

This NIHR-funded trial found that using intermittent pneumatic compression sleeves around the legs was effective in preventing deep vein thrombosis in immobile people after a stroke. When used on people admitted within three days of an acute stroke, this technique was inexpensive and also appeared to improve survival at six months. The results of this ...

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Electrical stimulation alongside other treatments may slightly improve ankle spasticity after stroke, but the clinical importance is uncertain

This systematic review and meta-analysis found that electrical stimulation produced a small, but statistically significant improvement, in tight muscles (spasticity) for people recovering from stroke. The clinical importance of the improvement is uncertain. For example, electrical stimulation improved joint flexibility by an average of 2.87 degrees and spasticity improved by 0.3 on a 5 point ...

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New drugs for deep vein thrombosis may offer a safe alternative to warfarin

This Cochrane systematic review found that two new types of drugs taken by mouth for deep vein thrombosis were as effective as standard treatment, which most commonly involves treatment by injection followed by warfarin tablets for at least three months. The new drugs have the advantage that they do not require monitoring or dose changes ...

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Self-management support for stroke survivors may improve independence

This NIHR-funded summary of systematic reviews looked at the evidence on self-management support for stroke survivors. It found that the term self-management was rarely used in the literature. There was high quality evidence that therapy-based rehabilitation, some of it including components supporting self-management, had a beneficial effect on the basic activities of daily living, such ...

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Centralising stroke services improves chances of patients getting the right care

This study of two models of organising stroke care showed that fully centralised services were more likely to deliver clinically effective treatments. This NIHR-funded study looked at stroke care audit data before and after introducing two different models of centralised stroke services in London and Manchester. The audit recorded the proportion of stroke patients in ...

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Occupational therapy several years after stroke does not improve function in severely ill care home residents

This trial found that a three-month individualised occupational therapy programme did not significantly improve the daily functioning (dressing, using the toilet and overall mobility) of severely physically and cognitively impaired people living in residential care who had a stroke on average three years before. About a quarter of stroke survivors in the UK cannot return ...

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Very early mobilisation following a stroke is no better than usual care

The AVERT trial found very early mobilisation - such as out-of-bed sitting, standing and walking - within 24 hours of stroke onset and at increased intensity, led to 4% fewer people with good recovery than usual care. No differences were found in death rates, overall disability scores, or in the time to be able to ...

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