Healthy lifestyle choices and emergency room interventions can help prevent first-time strokes, according to revised American Heart Association/American Stroke Association guidelines.
The guidelines, last updated in 2006, will be published in Stroke: Journal of the American Heart Association.
"Between 1999 and 2006, there's been over a 30 percent reduction in stroke death rates in the United States and we think the majority of the reduction is coming from better prevention," said Larry B. Goldstein, M.D., chairman of the statement writing committee and director of the Duke Stroke Center in Durham, N.C.
Prior to this, the incidence of stroke may have been increasing, according to the statement that cites a 39 percent rise in hospitalizations between 1988 and 1997. As the population continues to age, the total number of Americans having a stroke is expected to rise.
More than 77 percent of the 795,000 strokes occurring in Americans each year are first events. The third leading cause of death in the United States after heart disease and cancer, stroke is a significant economic and social burden and one of the major causes of disability in adults.
For the first time, the prevention guidelines address stroke as a broad continuum of related events, including ischemic stroke, non-ischemic stroke and transient ischemic attack (TIA). For prevention, there is often little difference along the stroke spectrum, said Goldstein, who is also a professor of medicine and director of Duke's ASA-Bugher Foundation Center for Stroke Prevention Research.
Accounting for 87 percent of all strokes, ischemic stroke happens when a blood vessel in or leading to the brain is blocked. TIA occurs when the blockage is temporary, but is considered a major risk factor for a later, larger stroke. A blood vessel rupture causes non-ischemic, or bleeding stroke, known as a hemorrhagic stroke.
The new guidelines feature several key prevention updates based on recent research:
Co-authors are: Cheryl D. Bushnell, M.D., M.H.S.; Robert J. Adams, M.S., M.D.; Lawrence J. Appel, M.D., M.P.H.; Lynne T. Braun, Ph.D., C.N.P.; Seemant Chaturvedi, M.D.; Mark A. Creager, M.D.; Antonio Culebras, M.D.; Robert H. Eckel, M.D.; Robert G. Hart, M.D.; Judith A. Hinchey, M.D., M.S.; Virginia J. Howard, Ph.D.; Edward C. Jauch, M.D., M.S.; Steven R. Levine, M.D.; James F. Meschia, M.D.; Wesley S. Moore, M.D.; J.V. (Ian) Nixon, M.D.; and Thomas A. Pearson, M.D. Individual author disclosures are on the manuscript.
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