Revised Guidelines on Stroke Prevention Include New Research and Advances

Healthy lifestyle choices and emergency room interventions can help prevent first-time strokes, according to revised American Heart Association/American Stroke Association guidelines. The guidelines were last updated in 2006.

“Between 1999 and 2006, there has been over a 30% reduction in stroke death rates in the United States and we think the majority of the reduction is coming from better prevention,” Larry B. Goldstein, MD, chairman of the statement writing committee and director of the Duke Stroke Center in Durham, N.C., stated in a press release.

Prior to this, the incidence of stroke may have been increasing. The statement cites a 39% rise in hospitalizations between 1988 and 1997. As the population continues to age, the total number of Americans having a stroke is expected to rise.

More than 77% of the 795,000 strokes occurring in Americans each year are first events. The third leading cause of death in the United States after heart disease and cancer, stroke is a significant economic and social burden and one of the major causes of disability in adults.

For the first time, the prevention guidelines address stroke as a broad continuum of related events, including ischemic stroke, non-ischemic stroke and transient ischemic attack (TIA). For prevention, there is often little difference along the stroke spectrum, according to Goldstein.

The new guidelines feature several key prevention updates based on recent research. They include healthy lifestyle choices including proper diet and exercise, changes that could lower the risk of stroke my as much as 80%. Additionally, emergency room physicians are asked to identify high-risk patients and make appropriate referrals for preventive therapy. For some people, genetic screening may be appropriate, though it is still not recommended for the general population. An aspirin regimen, while it will not prevent a first stroke in low-risk persons or those with diabetes or asymptomatic peripheral artery disease, it is recommended for those whose risk is high enough for the reduction in stroke risk to outweigh the bleeding risks of aspirin.

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