Heart and Stroke Groups Update Stroke Prevention Guidelines
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.
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