Treating metabolic syndrome may help prevent recurrent stroke or transient ischemic attack (TIA), according to updated guidelines issued by the American Heart Association and the American Stroke Association.

Among the key updates—the first revisions since 2006—is the suggestion that although the value of screening for metabolic syndrome after stroke is still not clear, if it is diagnosed, patients should be counseled to make the proper lifestyle changes. In addition, they should be treated for components of metabolic syndrome that are also stroke risk factors, particularly high BP and cholesterol.

The revised guidelines also state that either aspirin alone, aspirin combined with dipyridamole, or clopidogrel are reasonable options for stroke or TIA patients who need to take an antiplatelet drug to prevent recurrence (excluding persons whose stroke or TIA was caused by a clot from the heart).

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Authored by a group chaired by Karen L. Furie, MD, MPH, the guidelines were published online ahead of print in Stroke.

A separate report states that vitamin D deficiency is associated with fatal stroke among whites but not among blacks, even though blacks in the study generally were 60% more likely than whites to die from stroke.

In an analysis of the health records of 7,981 adults, whites with deficient vitamin D levels had double the risk of dying from stroke compared with whites with higher levels. But lead researcher Erin Michos, MD, MHS, and colleagues found no connection between vitamin D levels and stroke fatalities in black patients, despite their expectations.

“We thought the lower vitamin D levels might explain why blacks have higher risks for stroke, but we did not find the same relationship between vitamin D and stroke in blacks,” noted Dr. Michos in a statement detailing the findings, which were presented at the American Heart Association’s Scientific Sessions 2010.