Treating metabolic syndrome, undergoing carotid angioplasty

October 21, 2010

Treating metabolic syndrome and undergoing carotid angioplasty may prevent recurrent stroke or transient ischemic attack (TIA), according to revised American Heart Association/American Stroke Association guidelines.

Last updated in 2006, the evidence-based guidelines for doctors will be published in Stroke: Journal of the American Heart Association.

"Patients who've had a stroke or TIA are at highest risk for having another event," said Karen Furie, M.D., M.P.H., writing committee chair and stroke neurologist. "Since the last update, we've had results from several studies testing different interventions. We need to reevaluate the science every few years to optimize prevention."

Nearly a quarter of the 795,000 strokes in America each year happen in someone who has already had a stroke.

Ischemic stroke accounts for about 87 percent of all strokes, which are caused by a lack of blood to the brain, resulting in tissue death. TIA occurs when blockage of blood to the brain is only temporary and thus doesn't cause tissue death.

The new guidelines feature several key updates for stroke or TIA survivors, including:

  • The value of screening for metabolic syndrome after stroke is still not clear; however, if it's diagnosed, patients should receive counseling for (including diet, exercise and weight loss) and treatments for components that are also stroke risk factors, especially high blood pressure and .
  • If a stroke survivor has severe blockage of the carotid artery, angioplasty and stenting may be an alternative to surgery if he or she is at low risk for complications.
  • Excluding patients whose stroke or TIA was caused by a clot from the heart, among those taking an antiplatelet drug to prevent another stroke, either aspirin alone, aspirin combined with , or are reasonable options. Therefore, patients and doctors must consider risk factors, cost, tolerance and other characteristics to tailor the appropriate therapy.
  • Stroke or TIA survivors who are diabetic should follow existing guidelines for blood sugar control.
  • All stroke or TIA patients who have carotid artery blockage should aim for optimal medical therapy through a multifaceted approach, including antiplatelet drugs, statin therapy and lifestyle risk factor changes such as blood pressure management.
  • When patients with high stroke risk due to atrial fibrillation (an abnormal heart rhythm) need to temporarily stop taking the anti-clotting drug warfarin, they should receive low molecular weight heparin as bridging therapy to reduce the risk of blood clots.
is the most critical risk factor for . Doctors should work with patients to find the best drug regimen to suit each individual's blood pressure control needs, said Furie, director of the Massachusetts General Hospital Stroke Service and an associate professor at Harvard Medical School.

Related Stories

Recommended for you

Key discoveries offer significant hope of reversing antibiotic resistance

October 23, 2017
Resistance to antibiotics is becoming increasingly prevalent and threatens to undermine healthcare systems across the globe. Antibiotics including penicillins, cephalosporins and carbapenems are known as β-lactams and are ...

Novel therapies for multidrug-resistant bacteria

October 23, 2017
During this innovative study published in PLOS One, researchers found that novel classes of compounds, such as metal-complexes, can be used as alternatives to or to supplement traditional antibiotics, which have become ineffective ...

Exploring how herpes simplex virus changes when passed between family members

October 22, 2017
A new study explores how herpes simplex virus might change when passed from one individual to another, information that may prove useful in future development of therapeutics and vaccines. This rare glimpse into a transmission ...

Pneumonia vaccine under development provides 'most comprehensive coverage' to date, alleviates antimicrobial concerns

October 20, 2017
In 2004, pneumonia killed more than 2 million children worldwide, according to the World Health Organization. By 2015, the number was less than 1 million.

Newly discovered viral marker could help predict flu severity in infected patients

October 20, 2017
Flu viruses contain defective genetic material that may activate the immune system in infected patients, and new research published in PLOS Pathogens suggests that lower levels of these molecules could increase flu severity.

Migraines may be the brain's way of dealing with oxidative stress

October 19, 2017
A new perspective article highlights a compelling theory about migraine attacks: that they are an integrated mechanism by which the brain protects and repairs itself. Recent insightful findings and potential ways to use them ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.