A 75-year-old female presented to the Emergency department with a transient ischaemic attack.
Her only past medical history is type II diabetes of 20 year duration. Her blood pressure was 140/90 mmHg and ECG showed atrial fibrillation.
Which one of the following is most likely to prevent her from having a stroke?
ACE inhibitors
Aspirin
β blockers
Insulin
Warfarin (Correct)
If warfarin is contraindicated, aspirin should be used.
Reducing blood pressure (BP) by any class of anti-hypertensive reduces the risk of stroke.
HOPE study showed ACE-Is reduce the relative risk of stroke which may be independent of lowering BP.
Tight glycaemic control also reduces the risk of cerebrovascular events, however in the given scenario the
strongest stroke prevention strategy is warfarin.