Highlights
New Prevention Guidelines
In 2006, the American Heart Association and American Stroke Association released updated guidelines for preventing a second stroke among patients who have previously had a stroke or “mini-stroke” (transient ischemic attack [TIA]). The guidelines emphasize that another stroke is the greatest risk stroke or TIA survivors face, and that TIAs need to treated as aggressively as strokes. Prevention guidelines include:
- Lifestyle changes: Quit smoking, exercise 30 minutes a day, maintain a healthy weight and diet, limit alcohol consumption.
- Drug therapy: Antiplatelet drugs such as aspirin, dipyridamole, or clopidogrel; drugs to control cholesterol, high blood pressure, and high blood sugar.
- Surgery: Carotid endarterectomy or stenting is recommended to open narrowed neck arteries in most patients with severe blockage (greater than 70%) and some patients with moderate blockage (50 – 69%). It is not recommended for patients with mild blockage (less than 50%). An experienced surgeon with a good track record is essential.
Get Care Quickly
Research presented at the 2006 American Stroke Association conference suggested that patients who take an ambulance to the hospital are treated more quickly for stroke than patients who arrive on their own. Every second counts, and some types of treatment, such as clot-busting drugs, must be given within 3 hours of a stroke.
Diabetes and Metabolic Syndrome
- Diabetes is a leading risk factor for stroke, especially for adults who are newly diagnosed with type 2 diabetes and those who are younger than age 55. African Americans with diabetes are at especially high risk.
- Even pre-diabetes raises stroke risk. Researchers have identified metabolic syndrome, which occurs both in people who have diabetes and pre-diabetes, as an important risk factor. Metabolic syndrome’s signs include abdominal obesity, low HDL (“good”) cholesterol, high triglyceride levels, high blood pressure, and insulin resistance.
