Stroke rates in the United States are increasing, with over 500,000 people experiencing their first stroke each year. However, the American Stroke Association reports that up to 80% of strokes may be preventable through proper risk management and lifestyle adjustments. This week, the association released updated guidelines, the first in a decade, for stroke prevention. These new guidelines, titled the “2024 Guideline for the Primary Prevention of Stroke,” focus on identifying risk factors, especially in women, and promoting healthy habits to reduce stroke risk.
The guidelines emphasize the importance of primary prevention, which means stopping the first stroke before it occurs. According to Dr. Cheryl D. Bushnell, chair of the guideline writing group, some populations face a higher stroke risk due to factors such as genetics, lifestyle, or social determinants of health. Unfortunately, many people in these groups do not receive adequate screening to assess their risk levels, making prevention efforts even more critical.
A stroke happens when a blood clot blocks or a blood vessel ruptures, cutting off blood flow to the brain. This lack of oxygen can lead to severe brain damage, affecting one’s ability to think, speak, or move. In the U.S., stroke ranks as the fifth leading cause of death, contributing to nearly 160,000 deaths each year. Reducing this number through improved prevention strategies is a key focus of the updated guidelines.
For the first time, the guidelines outline specific stroke risk factors unique to women. Women are more vulnerable to strokes due to factors like preeclampsia during pregnancy, premature birth, and early menopause. The use of oral contraceptives, hormone replacement therapy, and estrogen for gender affirmation also raises the risk. Understanding these risks allows for more tailored prevention and monitoring strategies.
Beyond gender-specific risks, the guidelines address common risk factors that affect all individuals. These include lifestyle choices such as poor diet, smoking, lack of exercise, and poor sleep, which are all controllable. High cholesterol, high blood pressure, and high blood sugar levels are also highlighted as significant stroke risks. To reduce these risks, the guidelines recommend following a Mediterranean diet, engaging in regular physical activity, quitting smoking, and monitoring critical health indicators like cholesterol and blood pressure.
The new guidelines also emphasize the importance of risk assessment tools that can estimate an individual’s 10-year or 30-year risk of stroke and heart disease. These assessments help inform decisions about preventive treatments, such as the use of GLP-1 drugs like Ozempic, for people with diabetes or high heart disease risk. Additionally, knowing the early signs of a stroke, summarized by the acronym FAST (face drooping, arm weakness, speech difficulty, and time to call 911), is vital for getting immediate medical help and reducing the risk of lasting damage.
