Stroke is the third leading cause of death, behind heart disease and cancer. Risk factors associated with stroke are uniformly on the increase. These include most notably hypertension and diabetes, due primarily to the growing epidemic of obesity.
Deep vein thrombosis (DVT) can lead to pulmonary embolism. Its association with international jet travel has received recent notoriety.
Another risk factor, atrial fibrillation, present in nearly five million Americans, is encountered in about 15% of stroke victims. This figure increases with age.
Despite this, those at risk for stroke are not receiving the recommended anticoagulant therapy. This may be due in part to ignorance and in part to medico legal considerations. Unintended and sometimes unavoidable excessive anticoagulation can lead to a major internal bleed. In addition, some anticoagulant medications require regular monitoring via blood tests. Some can cross-react with numerous other medications. Diet and infection can have a dramatic impact on their efficacy.
Hans Larsen's new book: Thrombosis and Stroke Prevention carefully walks the concerned reader through this minefield of strokes, ischemic and hemorrhagic, and how best to avoid them. His well-researched tables comparing the risks and benefits of the various approaches to anticoagulation will not be found in the more traditional books on the topic. They are easily understood by the layman and provide the cold, hard numbers needed for making the difficult decisions involved in selecting the optimum stroke prevention protocol.
Hans Larsen studied with Henrik Dam, the Nobel Prize winning discoverer of vitamin K. Four of the 13 known blood coagulation factors are associated with vitamin K and Hans has well explained the intricacies of their actions as well as the actions of the components of platelet aggregation and the coagulation cascade. His easy style is especially suited to the difficult task of deciphering a topic as complex and tedious as blood coagulation. Like in his earlier book, Lone Atrial Fibrillation: Towards a Cure, his approach is comprehensive and unbiased. Recommendations are well reasoned, but at the end readers are left to draw their own now well- informed conclusions.
As the large cohort of baby boomers enters the ranks of seniordom, the topic of this book becomes more timely indeed.
Patrick Chambers MD