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:
High blood pressure is the most critical risk factor for recurrent stroke. 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.
Co-authors are: Scott E. Kasner, M.D.; Robert J. Adams, M.D.; Gregory W. Albers, M.D.; Ruth L. Bush, M.D., M.P.H.; Susan C. Fagan, Pharm.D.; Jonathan L. Halperin, M.D.; S. Claiborne Johnston, M.D., Ph.D.; Irene Katzan, M.D.; Walter N. Kernan, M.D.; Pamela H. Mitchell, Ph.D, R.N.; Bruce Ovbiagele, M.D.; Yuko Y. Palesch, Ph.D.; Ralph L. Sacco, M.D.; Lee H. Schwamm, M.D.; Sylvia Wassertheil-Smoller, M.D., Ph.D.; Tanya N. Turan, M.D.; and Deidre Wentworth, M.S.N., R.N.
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