Strokes are a leading cause of death and disability in the United States, but the American Stroke Association (ASA) reports that up to 80% of them are preventable. In its updated stroke prevention guidelines, the ASA emphasizes the importance of understanding and managing risk factors such as high blood pressure, high cholesterol, and diabetes.
Alongside medication, lifestyle changes, like regular physical activity, healthy eating, treating sleep disorders, and quitting smoking, play a crucial role in reducing stroke risk. This update comes after a decade since the last set of guidelines was published.
Dr. Cheryl Bushnell, a neurology expert from Wake Forest University, highlights how groundbreaking clinical trials have led to new medications that not only address diseases like diabetes and high cholesterol but also lower the risk of stroke.
For example, GLP-1 receptor agonists help reduce blood sugar and promote weight loss, thus decreasing stroke risk. Similarly, PCSK9 inhibitors effectively lower LDL cholesterol, further reducing stroke chances. These advances make the updated guidelines particularly timely, offering new tools for prevention.
The guidelines continue to recommend regular physical activity but with a greater emphasis on avoiding sedentary behavior. The ASA advises 150 minutes of moderate or 75 minutes of vigorous exercise weekly. However, the update now includes recommendations for monitoring and counseling against sitting for extended periods during the day. This shift underscores the critical role of physical activity, not just in preventing strokes, but also in promoting overall cardiovascular health.
The new guidelines also offer specific recommendations tailored to different groups, particularly women. Pregnant women are advised to manage high blood pressure and be screened for pregnancy complications, while all women are encouraged to be checked for early menopause, endometriosis, and other conditions that could affect stroke risk. Additionally, the ASA highlights the need to address adverse social determinants of health, such as limited access to healthcare, which can create barriers to effective prevention.
Overall, the updated guidelines reflect significant advances in research over the past decade. They not only aim to lower stroke risk but also enhance brain health and reduce the risk of dementia, which shares many of the same risk factors. Experts like Dr. Bradley Serwer emphasize the importance of early prevention, multidisciplinary collaboration, and implementing relatively simple strategies to help reduce the burden of stroke on individuals and society.
