Blood pressure control, lifestyle changes key to preventing subsequent strokes

May 1, 2014

Stroke survivors should control their blood pressure, cholesterol and weight and do moderate physical activity regularly to avoid having another stroke, according to an American Heart Association/American Stroke Association scientific statement.

They should also receive other evidence-based therapy specific to their individual health, which may include aspirin therapy or a surgical procedure to keep neck arteries open.

The statement, "Guidelines for the Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack (TIA)," is published in the American Heart Association journal Stroke.

"A vast amount of new research is revealing new and improved ways to protect patients with an ischemic or from having recurrent events and further brain damage," said Walter Kernan, M.D., lead author and chair of the guideline writing group and professor of medicine at Yale University School of Medicine in New Haven, Conn.

Treating is possibly most important for secondary prevention of ischemic stroke, according to the statement. About 70 percent of people who have had a recent ischemic also have high .

The statement notes that intensive cholesterol-lowering therapy is also important for survivors whose stroke was caused by hardened arteries. However, the association no longer recommends niacin or fibrate drugs to raise good cholesterol, due to sparse data establishing their effectiveness at reducing secondary stroke risk.

It's also good for stroke/TIA survivors capable of engaging in physical activity to have three to four sessions per week of moderate-vigorous intensity aerobic physical exercise such as walking briskly or riding a bike, according to the statement. Since the last update in 2011, the association added sections on nutrition, sleep apnea, aortic arch atherosclerosis and pre-diabetes.

New recommendations include:

  • Screening stroke and TIA survivors for diabetes and obesity
  • Possible screening for sleep apnea
  • Possible nutritional assessment
  • 30-day monitoring for irregular heart beat (atrial fibrillation) for those who had a stroke of unknown cause
  • Anticoagulants in specific situations
  • Following a Mediterranean-type diet that emphasizes vegetables, fruits, whole grains and includes low-fat dairy, poultry, fish, legumes and nuts and limits sweets and red meat

Clinical trials haven't proven the benefits of a Mediterranean diet after ischemic stroke or TIA, so statement recommendations are based on compelling but lower levels of research.

Each year in the United States, more than 690,000 adults have an ischemic stroke, which originate from blood clots that block blood flow in the brain or in a vessel leading to the brain.

Another 240,000 Americans will experience a TIA. Although TIA leaves no immediate impairment, survivors are at high risk for a future stroke.

On average, the annual risk for a future ischemic stroke after an initial ischemic stroke or TIA is about 3 percent to 4 percent.

"The key to staying healthy after an or TIA is careful and rapid assessment of the cause of the event and identification of so that appropriate preventive interventions can be quickly provided," Kernan said.

"Then, patients must work with their doctors regularly to stay on their prevention program. With this approach, every patient can look forward to a healthier future."

Explore further: Shingles linked to increased risk of stroke in young adults

Related Stories

Shingles linked to increased risk of stroke in young adults

January 2, 2014
Having shingles may increase the risk of having a stroke years later, according to research published in the January 2, 2014, online issue of Neurology, the medical journal of the American Academy of Neurology.

Unhealthiest stroke patients are less likely to get optimal care

November 20, 2013
(Medical Xpress)—Among thousands of hospital patients treated for a "mini stroke," those who were at highest risk for suffering a full-blown ischemic attack were less likely to received optimal care, according to a study ...

Consistent blood pressure control may cut rate of second stroke in half

March 27, 2014
Stroke survivors who consistently control their blood pressure may reduce the likelihood of a second stroke by more than half, according to new research in the American Heart Association journal Stroke.

Blood pressure medications given right after stroke not beneficial, study finds

February 19, 2014
A major study has found that giving stroke patients medications to lower their blood pressure during the first 48 hours after a stroke does not reduce the likelihood of death or major disability.

Depression has big impact on stroke, TIA survivors

March 29, 2012
Depression is more prevalent among stroke and transient ischemic attack survivors than in the general population, researchers reported in the American Heart Association's journal Stroke.

Cocaine may increase stroke risk within 24 hours of use

February 12, 2014
Cocaine greatly increases ischemic stroke risk in young adults within 24 hours of use, according to research presented at the American Stroke Association's International Stroke Conference 2014.

Recommended for you

New molecule may hold the key to triggering the regeneration and repair of damaged heart cells

August 21, 2017
New research has discovered a potential means to trigger damaged heart cells to self-heal. The discovery could lead to groundbreaking forms of treatment for heart diseases. For the first time, researchers have identified ...

Researchers investigate the potential of spider silk protein for engineering artificial heart

August 18, 2017
Ever more people are suffering from cardiac insufficiency, despite significant advances in preventing and minimising damage to the heart. The main cause of reduced cardiac functionality lies in the irreversible loss of cardiac ...

Lasers used to detect risk of heart attack and stroke

August 18, 2017
Patients at risk of heart attacks and strokes may be spotted earlier thanks to a diagnosis tool that uses near-infrared light to identify high-risk arterial plaques, according to research carried out at WMG, University of ...

Cholesterol crystals are sure sign a heart attack may loom

August 17, 2017
A new Michigan State University study on 240 emergency room patients shows just how much of a role a person's cholesterol plays, when in a crystallized state, during a heart attack.

How Gata4 helps mend a broken heart

August 15, 2017
During a heart attack, blood stops flowing into the heart; starved for oxygen, part of the heart muscle dies. The heart muscle does not regenerate; instead it replaces dead tissue with scars made of cells called fibroblasts ...

Injectable tissue patch could help repair damaged organs

August 14, 2017
A team of U of T Engineering researchers is mending broken hearts with an expanding tissue bandage a little smaller than a postage stamp.

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.