Healthy lifestyle choices and emergency room interventions reduced stroke death rates by more than 30% between 1999 and 2006, according to a scientific statement issued today by the American Heart Association.

Despite these advances, stroke remains the third leading cause of death in the United States, behind heart disease and cancer, and health officials expect the number of Americans who experience stroke to increase as the nation’s population continues to live longer.

More than 77% of the 795,000 strokes that occur each year in the United States are first time events, according to the AHA. Prevention remains the cornerstone to reducing the significant economic and social burden stroke causes, and the new AHA statement features several guideline updates for the first time since 1996.

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AHA guidelines emphasize that the following healthy lifestyle choices can lower the risk of a first stroke by as much as 80%: refraining from smoking cigarettes, eating a low-fat diet high in fruits and vegetables, drinking in moderation, exercising regularly and maintaining a normal body weight.

Other key points include the importance of identifying patients at high risk for stroke, conducting screening, making referrals and beginning preventive therapy early.

The guidelines urge clinicians to remember the following key points:

  • Although genetic screening is not recommended for the general population, family history and other extenuating circumstances may make it an appropriate option.
  • The usefulness of stenting or endarterectomy for patients who have not had symptoms remains unclear and should be decided on a case-by-case basis.
  • Screening the general population for carotid artery narrowing is not recommended.
  • Aspirin is recommended for patients whose risk is high enough that the reduced risk of stroke outweighs bleeding risks, but not for low-risk patients, those with diabetes or patients with asymptomatic peripheral artery disease.