Stroke Prevention Guidelines

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Stroke has published updated guidelines on primary prevention of stroke from the American Heart Association and the American Stroke Association. The guidelines take a patient-oriented approach, emphasizing healthy lifestyle choices.

Among the recommendations for clinicians:

  • All patients should have their stroke risk evaluated.
  • Systolic blood pressure should be targeted to below 140 mm Hg, with diastolic under 90 mm Hg. (The goal in diabetics is <130/80.)
  • An angiotensin-receptor blocker (ARB) or an angiotensin-converting–enzyme (ACE) inhibitor can help control blood pressure in adult diabetics.
  • Statins are recommended in patients with coronary heart disease and high-risk conditions such as diabetes.
  • Adjusted-dose warfarin (international normalized ratio target between 2.0 and 3.0) is recommended for high-risk patients with nonvalvular atrial fibrillation (use antiplatelet therapy with aspirin for low-risk afib patients).
  • Patients should reduce sodium intake and increase potassium intake. The DASH diet is recommended.

Stroke article (Free PDF)

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