AHA issues guidelines to prevent repeat stroke

Treating hypertension, obesity may cut repeat stroke risk
Treating hypertension, obesity may cut repeat stroke risk

HealthDay News – To prevent future strokes in transient ischemic attack and stroke patients, new guidelines from the American Heart Association recommend treating hypertension and dyslipidemia and screening for diabetes and obesity.

On average, the annual risk for future ischemic stroke after an initial ischemic stroke or TIA ranges 3-4%, according to research published in Stroke.

In order to update guidelines for the prevention of stroke in patients with stroke or TIA, Walter N. Kernan, MD, and colleagues from the Yale University School of Medicine conducted a comprehensive literature review.

New and revised guidelines include the clarification of parameters for initiating and resuming blood pressure therapy.

Blood pressure therapy should be initiated for previously untreated patients and should be resumed for previously treated patients with known hypertension who are beyond the first several days after stroke or TIA, the AHA reported.

Goals for target blood pressure should be individualized, wrote the researchers. Statin therapy with intensive lipid-lowering side effects is recommended for TIA and ischemic stroke patients presumed to be of atherosclerotic origin.

Other recommendations include screening for diabetes, obesity and sometimes sleep apnea. Nutritional assessments, monitoring for atrial fibrillation in those with stroke of unknown cause, anticoagulants for specific patients, and lifestyle modifications are also listed in the new recommendations.

"A vast amount of new research is revealing new and improved ways to protect patients with an ischemic stroke or transient ischemic attack from having recurrent events and further brain damage," Kernan said in a statement.

References

  1. Kernan, W et al. Stroke. 2014; doi: 10.1161/​STR.0000000000000024

Disclosures

Members of the writing committee and reviewers disclosed financial ties to the pharmaceutical and medical device industries; members of the committee also reported being witnesses in cases of medical malpractice and holding a patent on the RNA panel to identify TIA and risk strategy.

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