Materiały źródłowe

• #1 New guideline: Preventing a first stroke may be possible with screening, lifestyle changes | American Heart Association

  https://newsroom.heart.org/news/new-guideline-preventing-a-first-stroke-may-be-possible-with-screening-lifestyle-changes

  Each year in the U.S., over half a million people have a first stroke; however, up to 80% of strokes may be preventable. […] The new primary prevention of stroke guideline from the American Stroke Association urges health care professionals to screen people for stroke risk factors, including high blood pressure, elevated cholesterol, high blood sugar and obesity. […] Increasing public awareness and knowledge about healthy lifestyle changes, such as smoking cessation, increased physical activity, improved dietary habits and better sleep, may also help people reduce their stroke risk. […] Healthy lifestyle behaviors, such as good nutrition, smoking cessation and being physically active, along with routine health screenings and managing risk factors for cardiovascular disease and stroke with medication, can help prevent individuals from having a first stroke.

• #1 Stroke Prevention – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470234/

  Ayan Sabih; Prasanna Tadi; Anil Kumar. […] Stroke prevention follows a similar principle of controlling these risk factors. Risk factors important in stroke prevention can be divided into non-modifiable and modifiable risk factors. […] In most cases, the patient has a combination of modifiable risk factors, i.e., hypertension, diabetes, and high cholesterol. […] Hypertension is a major risk factor for both ischemic and hemorrhagic stroke. Hypertension is an identified risk factor in up to 90% of all strokes, and it is estimated that up to 40% of all strokes can be prevented with good blood pressure control. […] Diabetes is a major risk factor for ischemic stroke, especially lacunar stroke and large artery stroke. The risk of stroke is tripled in patients with diabetes mellitus of duration over 10 years.

• #1 Stroke Prevention: Practice Essentials, Overview, Primary Prevention of Stroke

  https://emedicine.medscape.com/article/323662-overview

  Cigarette smoking is directly correlated with an increased risk of both ischemic stroke and subarachnoid hemorrhage (SAH), with risk for the former approximately doubled by smoking and risk for the latter increased 2- to 4-fold. […] Diabetes is estimated to increase the relative risk of ischemic stroke 1.8- to nearly 6-fold, independent of other risk factors. […] Elevated total cholesterol has been linked to increased risk of ischemic stroke in a number of epidemiological studies. […] Embolism from atrial fibrillation (AF) associated left atrial thrombi accounts for approximately 10% of all ischemic strokes in the United States, and AF is associated with a 4- to 5-fold increase in the risk of ischemic stroke, independent of cardiac valve disease. […] Approximately 20% of ischemic strokes are caused by cardiogenic embolism.

• #1 Stroke Prevention – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470234/

  Ischemic stroke risk is increased by high cholesterol levels, whereas low cholesterol levels may increase the risk of hemorrhagic stroke. […] Smoking has been associated with a two to four-time increased risk of ischemic stroke and intracranial bleeds. It is one of the leading preventable risk factors for stroke. […] Regular exercise (burning 2000 to 3000 calories per week) has been shown to reduce stroke risk by half. […] The risk of ischemic stroke is increased by 22% for overweight individuals and by 64% in obese individuals as compared to normal-weight individuals. […] Chronic alcohol use and heavy drinking are risk factors for stroke. […] Atrial fibrillation by itself is a risk factor for embolic stroke events – atrial fibrillation leads to about a 1.9% risk of stroke per year and is responsible for as many as one in six strokes.

• #1 Stroke Prevention: Practice Essentials, Overview, Primary Prevention of Stroke

  https://emedicine.medscape.com/article/323662-overview

  Physical inactivity is associated with an increased risk of stroke and other adverse effects, such as cardiovascular morbidity and mortality. […] Although no clinical trials have tested the effect of weight loss on stroke risk, numerous studies have examined the relationship between weight or adiposity and risk of stroke. […] A healthy lifestyle includes elements such as smoking avoidance, appropriate body mass index, physical activity, vegetable consumption, and alcohol moderation. […] In 2014, the AHA and ASA again updated their guidelines, with new recommendations including the following for primary stroke prevention. […] Secondary prevention can be summarized by the mnemonic A, B, C, D, E, as follows: A – Antiaggregants (aspirin, clopidogrel, extended-release dipyridamole, ticlopidine) and anticoagulants (warfarin).

• #1 Stroke Prevention: Practice Essentials, Overview, Primary Prevention of Stroke

  https://emedicine.medscape.com/article/323662-overview

  Primary stroke prevention refers to the treatment of individuals with no history of stroke. Secondary stroke prevention refers to the treatment of individuals who have already had a stroke or transient ischemic attack. […] Risk-reduction measures in primary stroke prevention may include the use of antihypertensive medications, anticoagulants, platelet antiaggregants, 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins), smoking cessation, dietary intervention, weight loss, and exercise. […] Secondary prevention can be summarized by the mnemonic A, B, C, D, E, as follows: A – Antiaggregants (aspirin, clopidogrel, extended-release dipyridamole, ticlopidine) and anticoagulants (apixaban, dabigatran, edoxaban, rivaroxaban, warfarin) […] Smoking cessation, blood pressure control, diabetes control, a low-fat diet (eg, Dietary Approaches to Stop Hypertension [DASH] or Mediterranean diets), weight loss, and regular exercise should be encouraged.

• #1 7 things you can do to prevent a stroke – Harvard Health

  https://www.health.harvard.edu/womens-health/8-things-you-can-do-to-prevent-a-stroke

  Stroke prevention can start today. Protect yourself and avoid stroke, regardless of your age or family history. What can you do to prevent stroke? Age makes us more susceptible to having a stroke, as does having a mother, father, or other close relative who has had a stroke. You can’t reverse the years or change your family history, but there are many other stroke risk factors that you can control provided that you’re aware of them. Knowledge is power. If you know that a particular risk factor is sabotaging your health and predisposing you to a higher risk of stroke, you can take steps to alleviate the effects of that risk. […] High blood pressure is a huge factor, doubling or even quadrupling your stroke risk if it is not controlled. High blood pressure is the biggest contributor to the risk of stroke in both men and women. Monitoring blood pressure and, if it is elevated, treating it, is probably the biggest difference people can make to their vascular health.

• #1 Stroke Prevention: 10 Ways to Lower Your Risk of a Stroke

  https://www.healthline.com/health/stroke/stroke-prevention

  Some risk factors for stroke cant be controlled. But you may have some control over other risk factors, including your blood pressure, cholesterol levels, and many lifestyle choices. […] In this article, well examine 10 important stroke prevention steps and how each strategy may help lower your stroke risk. […] High blood pressure, or hypertension, is a major risk factor for stroke. High blood pressure significantly contributes to 90% of all strokes. The higher your blood pressure, the greater the risk. […] Managing blood pressure doesnt get easier with age, and by age 65, 2/3 of people have hypertension. […] Good blood pressure management may prevent about 40% of strokes. […] Diabetes is a significant risk factor for stroke. Stroke accounts for approximately 20% of deaths in people with diabetes, and people with prediabetes have a higher stroke risk, too.

• #1 AHA/ASA Stroke Secondary Prevention Guideline: Key Points

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2021/06/02/18/08/2021-Guideline-for-the-Prevention-of-Stroke

  Stroke survivors are at risk for developing a sedentary lifestyle and should be encouraged to be physically active. In patients with deficits that impair mobility, a supervised exercise program, such as one led by a physical therapist, can ensure exercise can be done safely. […] Atrial fibrillation is common in patients with ischemic stroke. Longer-term monitoring of heart rhythm increases the detection rate of atrial fibrillation. Most ischemic stroke patients with atrial fibrillation should be anticoagulated. […] In most stroke patients, atorvastatin 80 mg daily is recommended to reduce the risk of stroke recurrence and a low-density lipoprotein (LDL) of 70 mg/dl, consider adding ezetimibe. […] In stroke patients with diabetes, medical therapies and the goal for glycemic control should be individualized, but for most patients, a hemoglobin A1c of 7% is recommended.

• #1 Drugs in secondary stroke prevention

  https://australianprescriber.tg.org.au/articles/drugs-in-secondary-stroke-prevention.html

  After a stroke, patients are at risk of further ischaemic strokes, particularly in the first few weeks. Antiplatelet drugs, statins and antihypertensive drugs are the mainstay of pharmacotherapy for secondary stroke prevention. If dual antiplatelet therapy is used after a stroke, clinicians should ensure patients return to single drug therapy three weeks later. Patients with atrial fibrillation should be anticoagulated. Combinations of anticoagulants and antiplatelets should be avoided if possible. […] The target blood pressure should be less than 140 mmHg systolic. ACE inhibitors, calcium channel blockers or thiazide diuretics can be used. Statins are first-line treatment and a target low-density lipoprotein of less than 1.8 mmol/L is now recommended.

• #1 05. Stroke Prevention | Hospital Handbook

  https://hospitalhandbook.ucsf.edu/05-stroke-prevention/05-stroke-prevention

  Statin is recommended for those with a high 10-year risk for cardiovascular events (based on the AHA/ACC CV risk calculator), particularly for those with DM […] For AF patients with CHADS-VASC2 score 2 direct oral anticoagulants (apixaban, rivaroxaban, dabigatran), or warfarin with INR 2-3 is recommended for primary prevention of stroke […] For asymptomatic carotid stenosis patients, aspirin, statin, and evaluation for CEA in severe cases is recommended screening for carotid stenosis in low-risk, asymptomatic populations is not recommended […] Definition: prevention of 2nd stroke in patients with a history of TIA or ischemic stroke […] Important pillars include A. Risk factor control: Management of HTN, HLD, DM, smoking cessation, and lifestyle changes (diet, exercise, moderating alcohol, avoiding drugs)

• #1 Secondary Prevention of Ischemic Stroke: Updated Guidelines From AHA/ASA | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0100/p99.html

  In embolic stroke of an uncertain source, further workup with long-term cardiac monitoring, transesophageal echocardiography, and cardiac magnetic resonance imaging should be considered. […] In nonembolic strokes, antiplatelet therapy and cardiovascular risk reduction can reduce recurrent stroke risk. […] Neither anticoagulation nor antithrombotic therapy appears to reduce risk in embolic stroke of uncertain source. […] AHA/ASA guidelines recommend a blood pressure treatment goal of less than 130/80 mm Hg after all strokes and low-density lipoprotein cholesterol goals of less than 70 mg per dL (1.81 mmol per L) for nonembolic strokes. […] Although antiplatelet therapy reduces recurrent stroke after all nonembolic strokes, embolic strokes of an uncertain source do not appear to benefit from antiplatelet or anticoagulant therapy.

• #1 05. Stroke Prevention | Hospital Handbook

  https://hospitalhandbook.ucsf.edu/05-stroke-prevention/05-stroke-prevention

  B. Source control: Management of carotid stenosis, anticoagulation in AF, and antiplatelet therapy for all other events […] Guidelines recommend initiating BP therapy after the first several days for previously untreated patients with ischemic stroke or TIA with BP 140 /90 mmHg […] All stroke patients should be on intensive lipid-lowering therapy with a statin, starting in the acute setting […] The 2006 SPARCL trial (N Engl J Med (2006) 355:549 559) showed a 2.2% 5-year absolute risk reduction (13.1% down to 11.2%) in stroke patients randomized to atorvastatin 80mg vs placebo […] Use antiplatelet therapy, NOT anticoagulant therapy, for all non-cardioembolic stroke patients […] Dual antiplatelet therapy with aspirin and clopidogrel for stroke patients is reasonable for about 21 days after minor stroke or TIA then a single antiplatelet should be used to avoid hemorrhagic complications […] Closure of PFO may be effective in reducing the risk of recurrent stroke for young patients with cryptogenic stroke.

• #1

  https://www.fox5atlanta.com/news/new-stroke-prevention-guidelines-released-american-stroke-association-2024

  „These guidelines have several unique takeaway points, but focus on primary prevention with established strategies focused on better diet, exercise, avoiding tobacco, improving sleep quality and treating known risk factors such as diabetes, hypertension and hypercholesterolemia,” he said. […] „For example, the glucagon-like peptide (GLP-1) receptor agonists have been shown to not only drastically reduce blood sugars in patients with diabetes, but they also lead to significant weight loss in these patients, which has many downstream benefits,” she told Fox News Digital. […] „Together, this reduces the risk of stroke and other complications of diabetes.” […] „These medications have also been shown to reduce the risk of stroke,” she added. […] For stroke prevention, the ASA has historically recommended 150 minutes of moderate-intensity physical activity, 75 minutes of vigorous-intensity physical activity or a combination of both.

• #1 Drugs in secondary stroke prevention

  https://australianprescriber.tg.org.au/articles/drugs-in-secondary-stroke-prevention.html

  After an ischaemic stroke or transient ischaemic attack, patients have a high risk of having another stroke. Secondary stroke prevention includes antiplatelet therapy, statins and antihypertensives. […] Aspirin, clopidogrel, or a combination of aspirin with dipyridamole are first-line options for secondary stroke prevention in the absence of atrial fibrillation. […] Anticoagulants are indicated if the patient has atrial fibrillation. Avoid combinations of anticoagulants and antiplatelet drugs. […] Patients should be started on statins after an ischaemic stroke. High doses are recommended even if cholesterol concentrations are normal. […] Antihypertensive drugs are recommended for all patients with systolic blood pressures greater than 140/90 mmHg. ACE inhibitors, calcium channel blockers and diuretics are first-line options.

• #1 Stroke – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/stroke/symptoms-causes/syc-20350113

  Don’t use illicit drugs. Certain illicit drugs such as cocaine and methamphetamine are established risk factors for a TIA or a stroke. […] If you have had an ischemic stroke, you may need medicines to help lower your risk of having another stroke. If you have had a TIA, medicines can lower your risk of having a stroke in the future. These medicines may include: […] Anti-platelet drugs. Platelets are cells in the blood that form clots. Anti-platelet medicines make these cells less sticky and less likely to clot. The most commonly used anti-platelet medicine is aspirin. Your healthcare professional can recommend the right dose of aspirin for you. […] If you’ve had a TIA or minor stroke, you may take both an aspirin and an anti-platelet medicine such as clopidogrel (Plavix). These medicines may be prescribed for a period of time to reduce the risk of another stroke. If you can’t take aspirin, you may be prescribed clopidogrel alone. Ticagrelor (Brilinta) is another anti-platelet medicine that can be used for stroke prevention.

• #1 Stroke prevention strategies in high-risk patients with atrial fibrillation | Nature Reviews Cardiology

  https://www.nature.com/articles/s41569-020-00459-3

  Effective stroke prevention with oral anticoagulation (OAC) is the cornerstone of the management of patients with atrial fibrillation. The use of OAC reduces the risk of stroke and death. […] International guidelines for the management of AF recommend that OAC should be considered in all patients with AF and risk factors for stroke. […] In patients at high risk of stroke and bleeding, a tailored approach is needed to achieve a positive net clinical benefit of applied therapies (balancing the risks and the benefits of a treatment). […] Left atrial appendage closure can be considered as an alternative strategy for stroke prevention in patients with AF who have contraindications to OAC therapy. […] This Review provides an overview of stroke prevention strategies, including left atrial appendage occlusion, in patients with atrial fibrillation at high risk of stroke and bleeding.

• #1 Preventing Stroke | Stroke | CDC

  https://www.cdc.gov/stroke/prevention/index.html

  You can help prevent stroke by making healthy lifestyle choices. […] Many strokes can be prevented through healthy lifestyle changes and working with your health care team to control health conditions that raise your risk for stroke. […] Talk with your doctor about steps you can take to lower your risk for stroke. […] Choosing healthy meal and snack options can help you prevent stroke. […] Having overweight or obesity increases your risk for stroke. […] Physical activity can help you stay at a healthy weight and lower your cholesterol and blood pressure levels. […] Cigarette smoking greatly increases your chances of having a stroke. […] If you do smoke, quitting will lower your risk for stroke. […] Talk with your doctor about steps you can take to lower your risk for stroke.

• #1 New guideline: Preventing a first stroke may be possible with screening, lifestyle changes | American Heart Association

  https://newsroom.heart.org/news/new-guideline-preventing-a-first-stroke-may-be-possible-with-screening-lifestyle-changes

  Key stroke prevention recommendations include regular health screenings, identifying risk factors, lifestyle interventions and medications, when indicated. […] Unidentified and unmanaged cardiovascular disease risk factors can cause damage to arteries, the brain and the heart years before cardiovascular disease and stroke occur. […] Modifiable risk factors for stroke, such as high blood pressure, overweight and obesity, elevated cholesterol and elevated blood sugar, can be identified with physical exams and blood tests. […] The most common, treatable lifestyle behaviors that can help reduce stroke risk are detailed in the Associations Lifes Essential 8 cardiovascular health metrics. […] The guideline recommends that adults with no prior cardiovascular disease, as well as those with increased risk, follow a Mediterranean dietary pattern.

• #1 7 things you can do to prevent a stroke – Harvard Health

  https://www.health.harvard.edu/womens-health/8-things-you-can-do-to-prevent-a-stroke

  Smoking accelerates clot formation in a couple of different ways. It thickens your blood, and it increases the amount of plaque buildup in the arteries. Along with a healthy diet and regular exercise, smoking cessation is one of the most powerful lifestyle changes that will help you reduce your stroke risk significantly. […] If you have atrial fibrillation, get it treated. If you have symptoms such as heart palpitations or shortness of breath, see your doctor for an exam. You may need to take an anticoagulant drug (blood thinner), such as one of the direct-acting anticoagulant drugs to reduce your stroke risk from atrial fibrillation. Your doctors can guide you through this treatment. […] Keep your blood sugar under control. Monitor your blood sugar as directed by your doctor. Use diet, exercise, and medicines to keep your blood sugar within the recommended range.

• #1 7 things you can do to prevent a stroke – Harvard Health

  https://www.health.harvard.edu/womens-health/8-things-you-can-do-to-prevent-a-stroke

  Obesity, as well as the complications linked to it (including high blood pressure and diabetes), raises your odds of having a stroke. If you’re overweight, losing as little as 10 pounds can have a real impact on your stroke risk. […] Exercise contributes to losing weight and lowering blood pressure, but it also stands on its own as an independent stroke reducer. […] Drinking a little alcohol, such as an average of one per day, is okay. Once you start drinking more than two drinks per day, your risk goes up very sharply. […] Atrial fibrillation is a form of irregular heartbeat that causes clots to form in the heart. Those clots can then travel to the brain, producing a stroke. Atrial fibrillation carries almost a fivefold risk of stroke, and should be taken seriously. […] Having high blood sugar damages blood vessels over time, making clots more likely to form inside them.

• #1 Stroke – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/stroke/symptoms-causes/syc-20350113

  Lower the amount of cholesterol and saturated fat in your diet. Eating less cholesterol and fat, especially saturated fats and trans fats, may reduce buildup in the arteries. If you can’t control your cholesterol through dietary changes alone, you may need a cholesterol-lowering medicine. […] Quit tobacco use. Smoking raises the risk of stroke for smokers and nonsmokers exposed to secondhand smoke. Quitting lowers your risk of stroke. […] Manage diabetes. Diet, exercise and losing weight can help you keep your blood sugar in a healthy range. If lifestyle factors aren’t enough to control blood sugar, you may be prescribed diabetes medicine. […] Maintain a healthy weight. Being overweight contributes to other stroke risk factors, such as high blood pressure, cardiovascular disease and diabetes.

• #1 Stroke – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/stroke/symptoms-causes/syc-20350113

  Drink alcohol in moderation, if at all. Drinking large amounts of alcohol increases the risk of high blood pressure, ischemic strokes and hemorrhagic strokes. Alcohol also may interact with other medicines you’re taking. However, drinking small to moderate amounts of alcohol may help prevent ischemic stroke and decrease the blood’s clotting tendency. A small to moderate amount is about one drink a day. Talk to your healthcare professional about what’s appropriate for you. […] Treat obstructive sleep apnea (OSA). OSA is a sleep disorder that causes you to stop breathing for short periods several times during sleep. Your healthcare professional may recommend a sleep study if you have symptoms of OSA. Treatment includes a device that delivers positive airway pressure through a mask to keep the airway open while you sleep.

• #1 Preventing Another Stroke | American Stroke Association

  https://www.stroke.org/en/life-after-stroke/preventing-another-stroke

  Having a stroke puts you at a higher risk for a second one. However, there are things you can do to reduce your risk, starting with identifying what caused your stroke and learning your personal risk factors. […] Nearly 1 in 4 stroke survivors will have another stroke. Managing blood pressure, eating well and staying active, can help decrease your risk — talk to your doctor about managing these factors to help prevent another stroke. […] Take prescribed medications and check with your doctor before making any changes. […] Learn about the guideline released by the American Heart Association/American Stroke Association for prevention of stroke in patients with previous stroke or a transient ischemic attack (TIA). Schedule time with your doctor to better understand the steps you can take to reduce your chance of another stroke.

• #1 AHA/ASA Stroke Secondary Prevention Guideline: Key Points

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2021/06/02/18/08/2021-Guideline-for-the-Prevention-of-Stroke

  Patients with non-cardioembolic ischemic stroke should be treated with antiplatelet medication, rather than anticoagulation. […] For most ischemic stroke patients, there is no role for long-term dual antiplatelet therapy with the combination of aspirin and clopidogrel. Short-term dual antiplatelet treatment is recommended in selected patients with symptomatic intracranial atherosclerotic disease or with minor stroke or TIA. […] Patients with an embolic stroke of unclear source should not be treated empirically with anticoagulation or ticagrelor. […] Patients with a non-disabling ischemic stroke and ipsilateral severe extracranial carotid stenosis should have a carotid intervention soon after the stroke. The choice of intervention, between carotid endarterectomy and stenting, should be made based on patient comorbidities and vascular anatomy. […] Changing behavior to improve diet, exercise, and medication adherence can be challenging and multidisciplinary programs are generally more effective than simply advice or a written handout from a provider.

• #1 6. Antiplatelet Therapy for Ischemic Stroke and Transient Ischemic Attack | Canadian Stroke Best Practices

  https://www.strokebestpractices.ca/recommendations/secondary-prevention-of-stroke/anti-platelet-therapy-in-ischemic-stroke-and-tia

  All patients with acute ischemic stroke or transient ischemic attack not already on an antiplatelet agent should be treated with at least 160 mg of acetylsalicylic acid immediately as a one-time loading dose after brain imaging has excluded intracranial hemorrhage [Evidence Level A]. […] For patients with ischemic stroke or transient ischemic attack, antiplatelet therapy is recommended for long-term secondary stroke prevention to reduce the risk of recurrent stroke and other vascular events unless there is an indication for anticoagulant therapy [Evidence Level A]. […] Antiplatelet therapy should be started as soon as possible after brain imaging has excluded hemorrhage, within 24 hours of symptom onset (ideally within 12 hours) [Evidence Level B]. […] For long-term secondary stroke prevention, either acetylsalicylic acid (80 mg 325 mg daily), or clopidogrel (75 mg daily), or combined acetylsalicylic acid and extended-release dipyridamole (25mg/200 mg BID), are all appropriate treatment options and selection depends on patient factors or clinical circumstances [Evidence Level A].

• #1 Recurrent Ischemic Stroke: Strategies for Prevention | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1001/p436.html

  Clopidogrel monotherapy, 75 mg daily, is recommended for secondary prevention of stroke and can also be used in patients who are allergic to aspirin. […] The CHANCE (Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events) trial demonstrated that starting aspirin plus clopidogrel within 24 hours of a minor ischemic stroke or TIA and continuing it for up to 21 days may prevent recurrent stroke. […] Aspirin/dipyridamole, 25 mg/200 mg twice daily, is indicated for initial therapy after TIA or ischemic stroke for recurrent stroke prevention. […] Vitamin K antagonists such as warfarin (Coumadin) are no better than other antiplatelet therapies with increased bleeding risk, and they are not recommended for prevention of recurrent ischemic stroke.

• #1 6. Antiplatelet Therapy for Ischemic Stroke and Transient Ischemic Attack | Canadian Stroke Best Practices

  https://www.strokebestpractices.ca/recommendations/secondary-prevention-of-stroke/anti-platelet-therapy-in-ischemic-stroke-and-tia

  For patients with an acute high-risk transient ischemic attack or minor ischemic stroke of non-cardioembolic origin (NIHSS 0-3), who are not at high bleeding risk, dual antiplatelet therapy is recommended with clopidogrel 75 mg daily plus acetylsalicylic acid 81 mg daily for a duration of 21 days after the event, followed by antiplatelet monotherapy thereafter (acetylsalicylic acid or clopidogrel alone) [Evidence Level A]. […] Antiplatelet agents are considered a fundamental component of secondary stroke prevention. […] Several clinical trials have shown that antiplatelet medications (such as acetylsalicylic acid) reduce the risk of further vascular events after transient ischemic attack or ischemic stroke (25 percent relative risk reduction). […] Long-term treatment with both mono and dual antiplatelet therapy has been shown to reduce the risk of recurrent vascular events in persons with previous cardiovascular/cerebrovascular events.

• #1 Stroke Anticoagulation and Prophylaxis: Practice Essentials, Role of Anticoagulants, Anticoagulation for Acute Ischemic Stroke

  https://emedicine.medscape.com/article/1160021-overview

  Class I recommendations from the American Heart Association/American Stroke Association (AHA/ASA) for prevention of stroke in patients who have experienced noncardioembolic ischemic stroke or TIA are as follows: Antiplatelet agents rather than oral anticoagulation are recommended to reduce the risk of recurrent stroke and other cardiovascular events. […] Anticoagulation (target INR 2.5, range 2-3) for primary stroke prevention after MI is recommended in patients with the following risk factors: Persistent or paroxysmal atrial fibrillation, Left ventricular thrombus, Left ventricular aneurysm. […] The use of anticoagulation in cerebral venous sinus thrombosis is based on open case series with no controls. Anticoagulation has been used even in the presence of hemorrhagic infarctions typical of this condition. Authors have reported good outcomes compared with historical controls.

• #1 Recurrent Ischemic Stroke: Strategies for Prevention | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1001/p436.html

  Patient Information: See related handout on stroke prevention. […] Antiplatelet therapy is recommended to reduce the risk of recurrent ischemic stroke. […] Aspirin is recommended as initial treatment to prevent recurrent ischemic stroke. […] Clopidogrel is recommended as an alternative monotherapy and in patients allergic to aspirin. […] The combination of clopidogrel and aspirin is not recommended for long-term use (more than two to three years) because of increased bleeding risk. […] In patients with previous stroke or TIA, antiplatelet therapy should be used to reduce the risk of a recurrent event. […] The AHA/ASA guidelines recommend the use of anti-platelet agents to reduce the risk of a recurrent event. […] Aspirin, 50 to 325 mg daily, is recommended for initial therapy to prevent recurrent ischemic stroke.

• #1 Secondary prevention of stroke

  https://www.myamericannurse.com/secondary-prevention-of-stroke/

  Primary stroke prevention refers to prevention strategies in persons with no previous history of stroke or TIA. […] Secondary prevention refers to treatment strategies in persons whove already had a stroke or TIA, with the goal of preventing a recurrence. […] Stroke risk factors can be modifiable or nonmodifiable. Nonmodifiable risk factors include age, race, sex, ethnicity, and a family history of stroke or TIA. Modifiable factors include hypertension, hyperlipidemia, diabetes, and lifestyle factors. This article focuses on modifiable risk factors. […] The most recent prevention guidelines for stroke and TIA place greater emphasis on lifestyle, based on the growing evidence that supports the role of lifestyle modification in vascular risk reduction. […] Evidence shows that lowering blood pressure (BP) is effective in secondary stroke prevention.

• #1 Blood pressure management to prevent recurrent stroke: current evidence and perspectives | npj Cardiovascular Health

  https://www.nature.com/articles/s44325-024-00021-x

  A crucial takeaway from PROGRESS is that more intensive blood pressure lowering is linked to more pronounced benefits in reducing major vascular events. […] In summary, evidence from four randomized controlled trials and several meta-analyses underscores the advantage of treating patients with a history of stroke or transient ischemic attack to achieve a target blood pressure of 130/80mmHg. […] For patients with a history of stroke, reducing BPV is crucial for secondary stroke prevention. […] In conclusion, while significant progress has been made in understanding and managing blood pressure post-stroke, ongoing efforts are required to refine treatment targets, overcome challenges, and implement effective, personalized care strategies.

• #1 Comprehensive Strategies for Secondary Stroke Prevention | Consultant360

  https://www.consultant360.com/conference-coverage/comprehensive-strategies-secondary-stroke-prevention

  I also spoke about recommendations for physical activity. […] I also talked about smoking cessation. […] Important to point out that alcohol actually doesn’t have cardiovascular benefits, and to restrict alcohol intake. […] Beyond alcohol, also patients with stroke or TIA should be counseled not to use substances of abuse. […] Then I also talked about other things, like recommendations for treating high blood pressure. […] I also discussed hyperlipidemia—the importance of treating LDL cholesterol. […] The guidelines state that in patients with ischemic stroke or TIA with fasting triglycerides between 135 and 499 and well-controlled LDL, the use of icosapent ethyl, 2 g twice a day, is a reasonable thing to reduce the risk of recurrent stroke. […] I also discussed briefly glucose management.

• #1 Overview of secondary prevention of ischemic stroke – UpToDate

  https://www.uptodate.com/contents/overview-of-secondary-prevention-of-ischemic-stroke

  Overview of secondary prevention of ischemic stroke […] INTRODUCTION […] The management of treatable risk factors and common mechanisms of brain ischemia is important for reducing the risk of ischemic stroke. This topic will review the risk factors for stroke, with a focus on secondary prevention in patients who have a history of transient ischemic attack or ischemic stroke, or who have an elevated risk of ischemic stroke due to the presence of coronary heart disease or diabetes. […] APPROACH TO SECONDARY PREVENTION […] Most patients with an ischemic stroke or transient ischemic attack should be treated with all available risk reduction strategies, including antithrombotic therapy, blood pressure reduction, low-density lipoprotein cholesterol-lowering therapy, and lifestyle modification. By some estimates, treatment of all major stroke risk factors, compared with no treatment, would reduce the risk of recurrent stroke by 80 percent. […] Several important mechanisms of ischemic stroke are amenable to effective interventions for secondary prevention, including:

• #1 AHA/ASA 2021 Guidelines for Secondary Stroke Prevention – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/news/evidence-based-steps-to-prevent-further-strokes-after-a-first-ischemic-stroke-or-tia/

  Patients should be screened for atrial fibrillation, a common condition that puts patients at high risk for stroke. Patients diagnosed with atrial fibrillation should be started on blood-thinners to reduce recurrent stroke events. […] Antithrombotic therapy, including antiplatelet medications or anticoagulant medications, should be prescribed for nearly all stroke survivors who do not have contraindications. […] An important treatable cause of stroke is extracranial carotid artery disease. The guidelines suggest that patients who are appropriate candidates should have the stenosis fixed relatively early after their ischemic stroke. […] Since the previous guideline in 2014, several studies have assessed secondary stroke prevention of patent foramen ovale closure. It is currently considered reasonable to percutaneously close patent foramen ovale in younger patients with nonlacunar stroke or patients of any age with strokes of no other cause. […] Although this document provides guidance based on a review of the literature, it is essential for clinicians to collaboratively develop care plans with patients, incorporating patients wishes, goals, and concerns, the study authors stated.

• #1 Stroke Prevention – Programs – Institute for Stroke and Cerebrovascular Diseases – UTHealth Houston

  https://www.uth.edu/stroke-institute/programs/stroke-prevention

  The Stroke Prevention Program’s Research department is a pioneering center dedicated to advancing our understanding of stroke and developing effective strategies for prevention. […] The primary goals of this study are to determine whether treatment of obstructive sleep apnea (OSA) with positive airway pressure starting shortly after acute ischemic stroke or high risk TIA reduces recurrent stroke, acute coronary syndrome, and all-cause mortality during 6 months after the event, and improves stroke outcomes at 3 months in patients who experienced an ischemic stroke. […] The one year Stroke Prevention Fellowship is directed by Dr. Anjail Sharrief. The fellowship program focuses on giving physicians exposure and training in primary and secondary stroke prevention through risk factor management and stroke complication management. Fellows will be trained to provide patient-care and comprehensive preventive care.

• #1 Comprehensive Strategies for Secondary Stroke Prevention | Consultant360

  https://www.consultant360.com/conference-coverage/comprehensive-strategies-secondary-stroke-prevention

  Primary care physicians play a pivotal role in preventing recurrent stroke. […] I was discussing various ways of preventing stroke. One could say secondary stroke prevention, that is, in patients that already had ischemic stroke or transient ischemic attack (TIA), though the advice would actually also work for primary prevention of stroke or cardiovascular diseases in general. […] I talked about diets such as a Mediterranean-type diet or a DASH diet. These are both evidence-based diets that have been associated with lower rates of cardiovascular events. […] I talked a bit about salt restriction and trying to reduce sodium intake to maybe no more than, say, two or two and a half grams per day. […] In addition to speaking about diets in general, I also spoke about salt or sodium restriction, restricting the amount to two and a half grams per day of salt or less.

• #1 Stroke Prevention – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470234/

  Antiplatelet therapy is preferred for primary and secondary prevention of atherosclerotic stroke prevention. […] Anticoagulation therapy – COMPASS trial published in 2017 compared three antiplatelet regimens- rivaroxaban (2.5 mg twice daily) plus aspirin (100 mg once daily), rivaroxaban (5 mg twice daily), and aspirin (100 mg once daily) in patients with stable atherosclerotic disease. […] The structural cardiac disease can sometimes be corrected, though not all structural defect correction is beneficial for stroke prevention. […] The lifetime risk of stroke and mortality due to stroke is higher in women than men. […] Multiple risk factors increase the probability of stroke. Patients with identified risk factors can be educated in risk factors and decrease their risk. […] Stroke prevention is the responsibility of all healthcare workers.

• #1 Our Take: New stroke guidelines emphasize prevention through lifestyle changes > Beacon Health System

  https://www.beaconhealthsystem.org/news/2025/03/04/our-take-new-stroke-guidelines-emphasize-prevention-through-lifestyle-changes/

  Medical literature has clearly established that women face more adverse effects from stroke than men. […] Pregnant and postpartum individuals face approximately triple the risk of stroke compared with young adults of similar age, making blood pressure control before, during, and after pregnancy crucial for preventing both fatal and nonfatal stroke. […] The widespread use of hormonal contraception among women aged 15 to 49 years in the U.S. approximately 65% makes education about stroke risk particularly important. […] Sustaining a healthy brain over a lifetime is fundamental to maximizing overall ability and independence. […] Community education remains a critical domain within our Beacon Stroke System of Care. […] The key is to remember the framework of Lifes Simple 8 the four ideal health behaviors (Diet, Physical activity, Nicotine exposure, Sleep health) and the four ideal health factors (weight, blood lipids, blood glucose, and blood pressure). Each of these health metrics can be optimized individually to reduce stroke risk.

• #1 Stroke Prevention: Practice Essentials, Overview, Primary Prevention of Stroke

  https://emedicine.medscape.com/article/323662-overview

  Atherosclerotic stenosis in the extracranial internal carotid artery or carotid bulb is associated with an increased risk of stroke. […] Sickle cell disease (SCD) typically presents early in life with hemolytic anemia and vaso-occlusive manifestations, including stroke, particularly in children with homozygous disease. […] The Women’s Health Initiative (WHI) showed an increased risk of stroke with CEE therapy, particularly in older subgroups. […] Randomized clinical trials evaluating stroke risk with oral contraceptive (OC) use have not been performed. […] Depression is increasingly being recognized as a possible contributor to stroke. […] Several aspects of diet and nutrition can lead to increased blood pressure, including increased salt or sodium intake, decreased potassium intake, excess weight, and excess alcohol consumption.

• #1 Understanding the Updated Guidelines on Stroke Prevention

  https://www.smh.com/Home/News-Events/Health-News-Information/understanding-the-updated-guidelines-on-stroke-prevention

  Those with high or intermediate risk of stroke, even with no history of cardiovascular disease, should adhere to the Mediterranean Diet, supplemented with nuts and olive oil, to help prevent stroke. […] Maintaining a healthy blood pressure remains critical for stroke risk reduction. […] Management of hypertension is essential to the prevention of pregnancy-related stroke. […] Endometriosis, premature ovarian failure, and early-onset menopause can all contribute to increased risk of stroke and should be taken into account when screening for stroke risk. […] People taking estrogens also have increased risk of stroke, which should be accounted for when screening.

• #1 Prevent Stroke | Stroke Foundation – Australia

  https://strokefoundation.org.au/about-stroke/prevent-stroke

  Pregnancy can increase blood pressure, especially with pre-eclampsia and eclampsia, and it can also cause gestational diabetes. […] Oral contraception, particularly pills containing a higher dose of oestrogen. […] Hormone replacement therapy, which is associated with a small increase in the risk of stroke. […] Migraine with aura, which can affect blood vessels and make a stroke more likely.

• #1 Prevent Stroke | Stroke Foundation – Australia

  https://strokefoundation.org.au/about-stroke/prevent-stroke

  High blood pressure can damage the walls of blood vessels, and it can lead to heart problems. It can cause clots or plaques to break off and block an artery in the brain. High blood pressure is also the strongest risk factor for haemorrhagic stroke. […] Smoking doubles your risk of stroke by damaging blood vessel walls, increasing blood pressure, reducing oxygen in the blood, and making blood more likely to clot. […] Having had a stroke means you’re more likely to have another one. […] Older age makes a stroke more likely. Your doctor will consider your age with other risk factors. […] Being male means a higher stroke risk at nearly every age, even though women have their own risk factors like pregnancy, oral contraception and hormone replacement therapy. […] Family history can mean a higher stroke risk. For example, high cholesterol can run in families.

• #1

  https://consensus.app/questions/ischemic-stroke-prevention/

  Specific recommendations are provided for various conditions and populations. For instance, women, particularly during pregnancy and postmenopausal periods, require tailored prevention strategies. Other conditions such as hyperhomocysteinemia, hypercoagulable states, sickle cell disease, and cerebral venous sinus thrombosis also necessitate specialized approaches. […] The elderly population, especially those over 80, are at a higher risk for ischemic stroke. Prevention in this group involves vigilant monitoring and management of modifiable risk factors. Healthcare providers must adopt a multifaceted approach, addressing both individual and population-level factors to reduce the incidence and impact of stroke in older adults. […] Preventing ischemic stroke requires a comprehensive approach that includes both primary and secondary prevention strategies. Population-wide measures, targeted interventions for high-risk individuals, and specialized care for those with previous strokes or specific conditions are all essential components. By following evidence-based guidelines and recommendations, healthcare providers can significantly reduce the burden of ischemic stroke and improve patient outcomes.

• #1 Direct Oral Anticoagulants for Secondary Stroke Prevention

  https://practicalneurology.com/articles/2019-jan/direct-oral-anticoagulants-for-secondary-stroke-prevention

  Hypercoagulable states due to inherited or acquired systemic conditions (eg, autoimmune or malignancy) by definition predispose patients to arterial and venous thromboembolism, and are an ongoing risk for ischemic stroke that warrants indefinite anticoagulation. […] Decisions to switch from VKAs should be done with caution and with close discussion with a hematologist given the heterogeneity of disease processes and depending on the underlying pathophysiology. […] Although inherited thrombophilias have early data to support use of DOACs in the prevention of venous thromboembolism, and therefore possibly may also prevent against ischemic stroke, use of DOACs in antiphospholipid antibody syndrome is not currently recommended. […] Regardless of the indication, anticoagulant decisions need to be a shared decision after thoughtful discussion of the risks and benefits of the chosen therapy.

• #1 How to Stop a Stroke? BE FAST – Scripps Health

  https://www.scripps.org/news_items/6067-act-fast-to-stop-a-stroke

  Sickle cell disease: This genetic blood disorder increases the risk of stroke, especially in children and young adults. Early detection and regular care are important to lower this risk. […] Obesity: Excess weight contributes to other risk factors like high blood pressure and diabetes. Healthy eating and regular exercise can help maintain a healthy weight. […] Smoking: Smoking damages blood vessels and raises stroke risk. Quitting can significantly improve your health. […] Heavy alcohol use: Drinking too much alcohol can raise blood pressure and stroke risk. Moderation is key.

• #1 Prevent Stroke | Stroke Foundation – Australia

  https://strokefoundation.org.au/about-stroke/prevent-stroke

  Heart conditions like a hole in the heart (patent foramen ovale, or PFO) or heart disease, can cause a clot to form and travel to the brain. […] Blood disorders can make clots more likely. These include essential thrombocytosis, polycythaemia vera, antiphospholipid syndrome, and sickle cell anaemia. […] Autoimmune conditions can inflame the walls of blood vessels, making them narrower and more likely to clot. […] Infections, including bacterial heart infections and COVID-19, can cause clots. […] Medication including blood thinners, which reduce your chance of an ischaemic stroke or clot, can also mean a higher risk of a haemorrhagic stroke or bleed. […] Illegal drugs, such as amphetamine and cocaine, can increase your risk of stroke, especially bleeds. […] Trauma, such as an injury to the head or neck, can break blood vessels and cause a bleed or a clot.

• #1 Comprehensive Strategies for Secondary Stroke Prevention | Consultant360

  https://www.consultant360.com/conference-coverage/comprehensive-strategies-secondary-stroke-prevention

  So I discussed that a little bit. […] So I think the real key takeaways are to screen all patients with stroke or TIA and make sure they’re on the correct secondary stroke prevention therapies. […] Blood pressure should be treated aggressively. […] Cholesterol should be treated aggressively. […] In addition to that, important to talk about smoking cessation. […] Important to screen for atrial fibrillation also, which increases the risk of ischemic stroke. […] If atrial fibrillation isn’t present and anticoagulation isn’t necessary, then the patient with the history of ischemic stroke or TIA should be on antiplatelet therapy. […] Screening for sleep apnea is another thing that’s important in patients that have stroke. […] Multiple trials are testing whether even lower LDL cholesterol than current targets might provide incremental benefit. […] Other avenues of investigation include studying Lp(a)-lowering strategies to see if that class of drugs reduces the risk of ischemic events. […] So really, multiple lines of investigation. Novel antithrombotics as well, to see if we can further reduce the risk of recurrent stroke.

• #1 New guideline: Preventing a first stroke may be possible with screening, lifestyle changes | American Heart Association

  https://newsroom.heart.org/news/new-guideline-preventing-a-first-stroke-may-be-possible-with-screening-lifestyle-changes

  Physical activity is also essential for stroke risk reduction and overall heart health. […] New to the guideline is an emphasis on social determinants of health and the impact they have on stroke risk. […] Implementing the recommendations in this guideline would make it possible to significantly reduce the risk of people having a first stroke. […] The guideline highlights the need for risk assessment in primary stroke prevention and includes the use of risk prediction tools to estimate risk for atherosclerotic cardiovascular disease so that patients receive timely prevention and treatment strategies. […] According to the American Stroke Association, learning the warning signs of stroke and preventative measures are the best way to avoid strokes and keep them from happening again.

• #1 Secondary Prevention Of Stroke | Canadian Stroke Best Practices

  https://www.strokebestpractices.ca/recommendations/secondary-prevention-of-stroke

  This Secondary Prevention of Stroke module focuses on management of recurrent stroke risk reduction in patients who have experienced an initial stroke or transient ischemic attack. In some cases, this module will also guide healthcare providers with guidance for individuals at high risk of a stroke or transient ischemic attack based on current health status and the significant presence of one or more vascular risk factors. […] The 2020 update of the Canadian Stroke Best Practice Recommendations Secondary Prevention of Stroke module reinforces the growing and changing body of research evidence available to guide stroke prevention services. A coordinated and organized approach to assessment and aggressive risk factor management is emphasized throughout this module. […] Recommendations on virtual care for delivery of secondary stroke prevention.

• #2 CDC Grand Rounds: Public Health Strategies to Prevent and Treat Strokes | MMWR

  https://www.cdc.gov/mmwr/volumes/66/wr/mm6618a5.htm

  Worldwide, stroke is the second leading cause of death and a leading cause of serious long-term disability. […] Major advances in stroke prevention through treatment of known risk factors has led to stroke being considered largely preventable. […] Approximately 80% of strokes could be prevented by screening for and addressing known risks with measures such as improving hypertension control, smoking cessation, diabetes prevention, cholesterol management, increasing use of anticoagulation for atrial fibrillation, and eliminating excessive alcohol consumption. […] The goal of PCNASP is to implement effective, evidence-based, integrated systems for stroke prevention and treatment that provide 1) timely identification and transport of stroke patients to hospitals specializing in stroke care, 2) high-quality acute stroke treatment and rehabilitation, and 3) reintegration with primary care providers and the community to prevent recurrence of strokes by minimizing risk factors.

• #2 Secondary prevention of stroke

  https://www.myamericannurse.com/secondary-prevention-of-stroke/

  Primary stroke prevention refers to prevention strategies in persons with no previous history of stroke or TIA. […] Secondary prevention refers to treatment strategies in persons whove already had a stroke or TIA, with the goal of preventing a recurrence. […] Stroke risk factors can be modifiable or nonmodifiable. Nonmodifiable risk factors include age, race, sex, ethnicity, and a family history of stroke or TIA. Modifiable factors include hypertension, hyperlipidemia, diabetes, and lifestyle factors. This article focuses on modifiable risk factors. […] The most recent prevention guidelines for stroke and TIA place greater emphasis on lifestyle, based on the growing evidence that supports the role of lifestyle modification in vascular risk reduction. […] Evidence shows that lowering blood pressure (BP) is effective in secondary stroke prevention.

• #2 7 things you can do to prevent a stroke – Harvard Health

  https://www.health.harvard.edu/womens-health/8-things-you-can-do-to-prevent-a-stroke

  Stroke prevention can start today. Protect yourself and avoid stroke, regardless of your age or family history. What can you do to prevent stroke? Age makes us more susceptible to having a stroke, as does having a mother, father, or other close relative who has had a stroke. You can’t reverse the years or change your family history, but there are many other stroke risk factors that you can control provided that you’re aware of them. Knowledge is power. If you know that a particular risk factor is sabotaging your health and predisposing you to a higher risk of stroke, you can take steps to alleviate the effects of that risk. […] High blood pressure is a huge factor, doubling or even quadrupling your stroke risk if it is not controlled. High blood pressure is the biggest contributor to the risk of stroke in both men and women. Monitoring blood pressure and, if it is elevated, treating it, is probably the biggest difference people can make to their vascular health.

• #2 Stroke Prevention – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470234/

  Ayan Sabih; Prasanna Tadi; Anil Kumar. […] Stroke prevention follows a similar principle of controlling these risk factors. Risk factors important in stroke prevention can be divided into non-modifiable and modifiable risk factors. […] In most cases, the patient has a combination of modifiable risk factors, i.e., hypertension, diabetes, and high cholesterol. […] Hypertension is a major risk factor for both ischemic and hemorrhagic stroke. Hypertension is an identified risk factor in up to 90% of all strokes, and it is estimated that up to 40% of all strokes can be prevented with good blood pressure control. […] Diabetes is a major risk factor for ischemic stroke, especially lacunar stroke and large artery stroke. The risk of stroke is tripled in patients with diabetes mellitus of duration over 10 years.

• #2 7 things you can do to prevent a stroke – Harvard Health

  https://www.health.harvard.edu/womens-health/8-things-you-can-do-to-prevent-a-stroke

  Obesity, as well as the complications linked to it (including high blood pressure and diabetes), raises your odds of having a stroke. If you’re overweight, losing as little as 10 pounds can have a real impact on your stroke risk. […] Exercise contributes to losing weight and lowering blood pressure, but it also stands on its own as an independent stroke reducer. […] Drinking a little alcohol, such as an average of one per day, is okay. Once you start drinking more than two drinks per day, your risk goes up very sharply. […] Atrial fibrillation is a form of irregular heartbeat that causes clots to form in the heart. Those clots can then travel to the brain, producing a stroke. Atrial fibrillation carries almost a fivefold risk of stroke, and should be taken seriously. […] Having high blood sugar damages blood vessels over time, making clots more likely to form inside them.

• #2 Stroke Prevention: Practice Essentials, Overview, Primary Prevention of Stroke

  https://emedicine.medscape.com/article/323662-overview

  Cigarette smoking is directly correlated with an increased risk of both ischemic stroke and subarachnoid hemorrhage (SAH), with risk for the former approximately doubled by smoking and risk for the latter increased 2- to 4-fold. […] Diabetes is estimated to increase the relative risk of ischemic stroke 1.8- to nearly 6-fold, independent of other risk factors. […] Elevated total cholesterol has been linked to increased risk of ischemic stroke in a number of epidemiological studies. […] Embolism from atrial fibrillation (AF) associated left atrial thrombi accounts for approximately 10% of all ischemic strokes in the United States, and AF is associated with a 4- to 5-fold increase in the risk of ischemic stroke, independent of cardiac valve disease. […] Approximately 20% of ischemic strokes are caused by cardiogenic embolism.

• #2 Stroke Prevention: 10 Ways to Lower Your Risk of a Stroke

  https://www.healthline.com/health/stroke/stroke-prevention

  The risk of stroke in someone who has overweight is 22% higher than a person at a moderate weight. For people with obesity, the risk is 64% higher. […] Exercise can support your heart health and reduce your risk of stroke. […] Research increasingly makes it clear that poor sleep quality may increase your risk of stroke. […] Atrial fibrillation (AF or Afib) is a type of heart arrhythmia or irregular heartbeat. If you have Afib, you have a higher risk of stroke and blood clots. […] Eating a nutritious and balanced diet can help you lose weight and positively impact other issues that can contribute to stroke risk. […] If you have an increased risk of a stroke, you can work closely with your doctor to understand how to reduce your risk factors as much as you can. […] Many of the strategies for stroke prevention can also support your overall health and may even reduce your risk of other health conditions.

• #2 Updated Guideline for Primary Prevention of Stroke Released

  https://www.uspharmacist.com/article/updated-guideline-for-primary-prevention-of-stroke-released

  A new clinical guideline for primary stroke prevention from the American Stroke Association, a division of the American Heart Association (AHA), was recently published in the journal Stroke. […] The new guideline provides clinical evidence-based recommendations for strategies for supporting brain health and thwarting stroke throughout a person’s lifespan by improving healthy lifestyle behaviors and getting preventive care. […] The new primary prevention of stroke guideline urges clinicians to screen patients for stroke risk factors, including hypertension, hyperlipidemia, diabetes, and obesity. […] The updated guidelines highlight essential stroke prevention recommendations, including regular health screening, identifying and managing risk factors, lifestyle interventions, and medications based on individual patient needs.

• #2 Blood pressure management to prevent recurrent stroke: current evidence and perspectives | npj Cardiovascular Health

  https://www.nature.com/articles/s44325-024-00021-x

  Hypertension is the leading risk factor for stroke, causing about 60% of cases. Effective blood pressure control is vital for preventing recurrent ischemic strokes, with studies showing mixed results. […] Current evidence states the significant benefits of managing hypertension in stroke survivors, with some studies suggesting that stringent blood pressure control can substantially decrease the likelihood of subsequent strokes and other cardiovascular complications. In summary, blood pressure reduction in the chronic stage of stroke is highly effective in preventing recurrent strokes, protecting cardiovascular health, preserving cognitive function, and reducing overall mortality. […] The ideal blood pressure target for individuals who have experienced a stroke has not yet been established by randomised controlled trials. Current guidelines suggest maintaining a blood pressure consistently below 140/90mmHg for those who have suffered a cerebrovascular event.

• #2 Get serious about stroke prevention | American Diabetes Association

  https://diabetes.org/about-diabetes/complications/stroke

  Get serious about stroke prevention. […] Living with diabetes heightens your risk of getting a stroke. […] Understanding your risk factors, implementing healthy lifestyle changes, keeping tight blood glucose (blood sugar) control, and more will all lower your risk of ever getting a stroke. […] Having diabetes raises your risk for stroke. […] You can lower your chances of having a stroke by taking care of your diabetes and tackling some of the other risk factors, such as losing weight if you’re overweight. […] Lower your risk by keeping your blood glucose, blood pressure, and cholesterol on target with healthy eating, physical activity, and, if needed, medicine. […] Every step you take will help. The closer your numbers are to your targets, the better your chances of preventing a stroke.

• #2 AHA/ASA Stroke Secondary Prevention Guideline: Key Points

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2021/06/02/18/08/2021-Guideline-for-the-Prevention-of-Stroke

  Stroke survivors are at risk for developing a sedentary lifestyle and should be encouraged to be physically active. In patients with deficits that impair mobility, a supervised exercise program, such as one led by a physical therapist, can ensure exercise can be done safely. […] Atrial fibrillation is common in patients with ischemic stroke. Longer-term monitoring of heart rhythm increases the detection rate of atrial fibrillation. Most ischemic stroke patients with atrial fibrillation should be anticoagulated. […] In most stroke patients, atorvastatin 80 mg daily is recommended to reduce the risk of stroke recurrence and a low-density lipoprotein (LDL) of 70 mg/dl, consider adding ezetimibe. […] In stroke patients with diabetes, medical therapies and the goal for glycemic control should be individualized, but for most patients, a hemoglobin A1c of 7% is recommended.

• #2 Stroke prevention strategies in high-risk patients with atrial fibrillation | Nature Reviews Cardiology

  https://www.nature.com/articles/s41569-020-00459-3

  Effective stroke prevention with oral anticoagulation (OAC) is the cornerstone of the management of patients with atrial fibrillation. The use of OAC reduces the risk of stroke and death. […] International guidelines for the management of AF recommend that OAC should be considered in all patients with AF and risk factors for stroke. […] In patients at high risk of stroke and bleeding, a tailored approach is needed to achieve a positive net clinical benefit of applied therapies (balancing the risks and the benefits of a treatment). […] Left atrial appendage closure can be considered as an alternative strategy for stroke prevention in patients with AF who have contraindications to OAC therapy. […] This Review provides an overview of stroke prevention strategies, including left atrial appendage occlusion, in patients with atrial fibrillation at high risk of stroke and bleeding.

• #2 Stroke – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/stroke/symptoms-causes/syc-20350113

  Blooding-thinning medicines, known as anticoagulants. These medicines reduce blood clotting. Heparin is a fast-acting anticoagulant that may be used short-term in the hospital. […] Slower acting warfarin (Jantoven) may be used over a longer term. Warfarin is a powerful blood-thinning medicine, so you need to take it exactly as directed and watch for side effects. You also need regular blood tests to monitor warfarin’s effects. […] Several newer blood-thinning medicines are available to prevent strokes in people who have a high risk. These medicines include dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis) and edoxaban (Savaysa). They work faster than warfarin and usually don’t require regular blood tests or monitoring by your healthcare professional. These medicines also are associated with a lower risk of bleeding complications compared to warfarin.

• #2 Understanding the Updated Guidelines on Stroke Prevention

  https://www.smh.com/Home/News-Events/Health-News-Information/understanding-the-updated-guidelines-on-stroke-prevention

  Those with high or intermediate risk of stroke, even with no history of cardiovascular disease, should adhere to the Mediterranean Diet, supplemented with nuts and olive oil, to help prevent stroke. […] Maintaining a healthy blood pressure remains critical for stroke risk reduction. […] Management of hypertension is essential to the prevention of pregnancy-related stroke. […] Endometriosis, premature ovarian failure, and early-onset menopause can all contribute to increased risk of stroke and should be taken into account when screening for stroke risk. […] People taking estrogens also have increased risk of stroke, which should be accounted for when screening.

• #2 Stroke – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/stroke/symptoms-causes/syc-20350113

  Eat a diet rich in fruits and vegetables. Eating five or more servings of fruits or vegetables every day may reduce the risk of stroke. The Mediterranean diet, which emphasizes olive oil, fruit, nuts, vegetables and whole grains, may be helpful. […] Exercise regularly. Aerobic exercise reduces the risk of stroke in many ways. Exercise can lower blood pressure, increase the levels of good cholesterol, and improve the overall health of the blood vessels and heart. It also helps you lose weight, control diabetes and reduce stress. Gradually work up to at least 30 minutes of moderate physical activity on most or all days of the week. The American Heart association recommends getting 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous aerobic activity a week. Moderate intensity activities can include walking, jogging, swimming and bicycling.

• #2 Stroke – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/stroke/symptoms-causes/syc-20350113

  Drink alcohol in moderation, if at all. Drinking large amounts of alcohol increases the risk of high blood pressure, ischemic strokes and hemorrhagic strokes. Alcohol also may interact with other medicines you’re taking. However, drinking small to moderate amounts of alcohol may help prevent ischemic stroke and decrease the blood’s clotting tendency. A small to moderate amount is about one drink a day. Talk to your healthcare professional about what’s appropriate for you. […] Treat obstructive sleep apnea (OSA). OSA is a sleep disorder that causes you to stop breathing for short periods several times during sleep. Your healthcare professional may recommend a sleep study if you have symptoms of OSA. Treatment includes a device that delivers positive airway pressure through a mask to keep the airway open while you sleep.

• #2 Stroke Prevention – Programs – Institute for Stroke and Cerebrovascular Diseases – UTHealth Houston

  https://www.uth.edu/stroke-institute/programs/stroke-prevention

  The Stroke Prevention Program’s Research department is a pioneering center dedicated to advancing our understanding of stroke and developing effective strategies for prevention. […] The primary goals of this study are to determine whether treatment of obstructive sleep apnea (OSA) with positive airway pressure starting shortly after acute ischemic stroke or high risk TIA reduces recurrent stroke, acute coronary syndrome, and all-cause mortality during 6 months after the event, and improves stroke outcomes at 3 months in patients who experienced an ischemic stroke. […] The one year Stroke Prevention Fellowship is directed by Dr. Anjail Sharrief. The fellowship program focuses on giving physicians exposure and training in primary and secondary stroke prevention through risk factor management and stroke complication management. Fellows will be trained to provide patient-care and comprehensive preventive care.

• #2 Overview of secondary prevention of ischemic stroke – UpToDate

  https://www.uptodate.com/contents/overview-of-secondary-prevention-of-ischemic-stroke

  Overview of secondary prevention of ischemic stroke […] INTRODUCTION […] The management of treatable risk factors and common mechanisms of brain ischemia is important for reducing the risk of ischemic stroke. This topic will review the risk factors for stroke, with a focus on secondary prevention in patients who have a history of transient ischemic attack or ischemic stroke, or who have an elevated risk of ischemic stroke due to the presence of coronary heart disease or diabetes. […] APPROACH TO SECONDARY PREVENTION […] Most patients with an ischemic stroke or transient ischemic attack should be treated with all available risk reduction strategies, including antithrombotic therapy, blood pressure reduction, low-density lipoprotein cholesterol-lowering therapy, and lifestyle modification. By some estimates, treatment of all major stroke risk factors, compared with no treatment, would reduce the risk of recurrent stroke by 80 percent. […] Several important mechanisms of ischemic stroke are amenable to effective interventions for secondary prevention, including:

• #2 Recurrent Ischemic Stroke: Strategies for Prevention | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1001/p436.html

  Patient Information: See related handout on stroke prevention. […] Antiplatelet therapy is recommended to reduce the risk of recurrent ischemic stroke. […] Aspirin is recommended as initial treatment to prevent recurrent ischemic stroke. […] Clopidogrel is recommended as an alternative monotherapy and in patients allergic to aspirin. […] The combination of clopidogrel and aspirin is not recommended for long-term use (more than two to three years) because of increased bleeding risk. […] In patients with previous stroke or TIA, antiplatelet therapy should be used to reduce the risk of a recurrent event. […] The AHA/ASA guidelines recommend the use of anti-platelet agents to reduce the risk of a recurrent event. […] Aspirin, 50 to 325 mg daily, is recommended for initial therapy to prevent recurrent ischemic stroke.

• #2 05. Stroke Prevention | Hospital Handbook

  https://hospitalhandbook.ucsf.edu/05-stroke-prevention/05-stroke-prevention

  B. Source control: Management of carotid stenosis, anticoagulation in AF, and antiplatelet therapy for all other events […] Guidelines recommend initiating BP therapy after the first several days for previously untreated patients with ischemic stroke or TIA with BP 140 /90 mmHg […] All stroke patients should be on intensive lipid-lowering therapy with a statin, starting in the acute setting […] The 2006 SPARCL trial (N Engl J Med (2006) 355:549 559) showed a 2.2% 5-year absolute risk reduction (13.1% down to 11.2%) in stroke patients randomized to atorvastatin 80mg vs placebo […] Use antiplatelet therapy, NOT anticoagulant therapy, for all non-cardioembolic stroke patients […] Dual antiplatelet therapy with aspirin and clopidogrel for stroke patients is reasonable for about 21 days after minor stroke or TIA then a single antiplatelet should be used to avoid hemorrhagic complications […] Closure of PFO may be effective in reducing the risk of recurrent stroke for young patients with cryptogenic stroke.

• #2 AHA/ASA 2021 Guidelines for Secondary Stroke Prevention – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/news/evidence-based-steps-to-prevent-further-strokes-after-a-first-ischemic-stroke-or-tia/

  Patients should be screened for atrial fibrillation, a common condition that puts patients at high risk for stroke. Patients diagnosed with atrial fibrillation should be started on blood-thinners to reduce recurrent stroke events. […] Antithrombotic therapy, including antiplatelet medications or anticoagulant medications, should be prescribed for nearly all stroke survivors who do not have contraindications. […] An important treatable cause of stroke is extracranial carotid artery disease. The guidelines suggest that patients who are appropriate candidates should have the stenosis fixed relatively early after their ischemic stroke. […] Since the previous guideline in 2014, several studies have assessed secondary stroke prevention of patent foramen ovale closure. It is currently considered reasonable to percutaneously close patent foramen ovale in younger patients with nonlacunar stroke or patients of any age with strokes of no other cause. […] Although this document provides guidance based on a review of the literature, it is essential for clinicians to collaboratively develop care plans with patients, incorporating patients wishes, goals, and concerns, the study authors stated.

• #2 Long-term antithrombotic therapy for the secondary prevention of ischemic stroke – UpToDate

  https://www.uptodate.com/contents/long-term-antithrombotic-therapy-for-the-secondary-prevention-of-ischemic-stroke

  Long-term antithrombotic therapy for the secondary prevention of ischemic stroke […] Antiplatelet therapy is used for both the management of acute ischemic stroke and for the prevention of stroke. Antiplatelet therapy reduces the incidence of stroke in patients at high risk for atherosclerosis and in those with known symptomatic cerebrovascular disease. […] Antiplatelet therapy for secondary stroke prevention will be reviewed here. […] Importantly, despite evidence of benefit with short-term use in acute ischemic stroke, aspirin and clopidogrel should not be used in combination for long-term stroke prevention, given the lack of greater efficacy compared with either agent alone, and given the substantially increased risk of bleeding complications.

• #2

  https://link.springer.com/article/10.1007/s13311-023-01352-w

  For non-cardioembolic stroke, antiplatelet therapy is recommended. […] Long-term antiplatelet monotherapy is the treatment of choice for secondary stroke prevention in patients with non-cardioembolic stroke. […] Anticoagulation for stroke prevention is reserved for patients with proven AF, known cardiac or arterial thrombus, mechanical heart valves, or selected hypercoagulable disorders. […] The available anticoagulants for stroke prevention include warfarin and direct oral anticoagulants (DOACs). […] Managing hyperlipidemia is another important aspect of secondary stroke prevention. Specifically, statin therapy is proven to lower the risk of stroke recurrence. […] Therefore for patients who have experienced an ischemic stroke and have an LDL cholesterol greater than 100 mg/dL, it is recommended to start a high intensity statin such as 80 mg of atorvastatin or 20-40 mg of rosuvastatin to reduce the risk of secondary stroke. […] The management of both vascular and lifestyle risk factors remains central to the prevention of secondary stroke.

• #2 Practice advisory update: Patent foramen ovale and secondary stroke prevention

  https://www.aan.com/Guidelines/home/GuidelineDetail/991

  This practice advisory updates the AAN’s 2016 practice advisory on closure of patent foramen ovale (PFO). The practice advisory concludes that, while the absolute risk reduction is not large, there is likely a clinically meaningful benefit for younger patients. Importantly, there is also a small upfront risk of procedural complication and an increased risk of developing atrial fibrillation after the procedure. Clinicians should discuss risks and benefits of PFO closures with patients. […] Endorsed by the Society for Cardiovascular Angiography, the American Heart Association/American Stroke Association, and the European Academy of Neurology.

• #2 Comprehensive Strategies for Secondary Stroke Prevention | Consultant360

  https://www.consultant360.com/conference-coverage/comprehensive-strategies-secondary-stroke-prevention

  So I discussed that a little bit. […] So I think the real key takeaways are to screen all patients with stroke or TIA and make sure they’re on the correct secondary stroke prevention therapies. […] Blood pressure should be treated aggressively. […] Cholesterol should be treated aggressively. […] In addition to that, important to talk about smoking cessation. […] Important to screen for atrial fibrillation also, which increases the risk of ischemic stroke. […] If atrial fibrillation isn’t present and anticoagulation isn’t necessary, then the patient with the history of ischemic stroke or TIA should be on antiplatelet therapy. […] Screening for sleep apnea is another thing that’s important in patients that have stroke. […] Multiple trials are testing whether even lower LDL cholesterol than current targets might provide incremental benefit. […] Other avenues of investigation include studying Lp(a)-lowering strategies to see if that class of drugs reduces the risk of ischemic events. […] So really, multiple lines of investigation. Novel antithrombotics as well, to see if we can further reduce the risk of recurrent stroke.

• #2 Diet for stroke prevention | Stroke and Vascular Neurology

  https://svn.bmj.com/content/3/2/44

  Patients at risk of stroke should limit their intake of animal flesh, avoiding red meat and egg yolk. They should have a high intake of beneficial oils such as olive and canola, whole grains, vegetables, fruits and legumes. […] Diet is an important part of stroke prevention. Reducing sodium intake, avoiding egg yolks, limiting the intake of animal flesh (particularly red meat), and increasing the intake of whole grains, fruits, vegetables and lentils would contribute importantly to reversing the trend to increased cardiovascular risk in China.

• #2 Our Take: New stroke guidelines emphasize prevention through lifestyle changes > Beacon Health System

  https://www.beaconhealthsystem.org/news/2025/03/04/our-take-new-stroke-guidelines-emphasize-prevention-through-lifestyle-changes/

  Medical literature has clearly established that women face more adverse effects from stroke than men. […] Pregnant and postpartum individuals face approximately triple the risk of stroke compared with young adults of similar age, making blood pressure control before, during, and after pregnancy crucial for preventing both fatal and nonfatal stroke. […] The widespread use of hormonal contraception among women aged 15 to 49 years in the U.S. approximately 65% makes education about stroke risk particularly important. […] Sustaining a healthy brain over a lifetime is fundamental to maximizing overall ability and independence. […] Community education remains a critical domain within our Beacon Stroke System of Care. […] The key is to remember the framework of Lifes Simple 8 the four ideal health behaviors (Diet, Physical activity, Nicotine exposure, Sleep health) and the four ideal health factors (weight, blood lipids, blood glucose, and blood pressure). Each of these health metrics can be optimized individually to reduce stroke risk.

• #2 Prevent Stroke | Stroke Foundation – Australia

  https://strokefoundation.org.au/about-stroke/prevent-stroke

  Pregnancy can increase blood pressure, especially with pre-eclampsia and eclampsia, and it can also cause gestational diabetes. […] Oral contraception, particularly pills containing a higher dose of oestrogen. […] Hormone replacement therapy, which is associated with a small increase in the risk of stroke. […] Migraine with aura, which can affect blood vessels and make a stroke more likely.

• #2 Stroke Anticoagulation and Prophylaxis: Practice Essentials, Role of Anticoagulants, Anticoagulation for Acute Ischemic Stroke

  https://emedicine.medscape.com/article/1160021-overview

  In patients with cerebral ischemia of unknown origin who are younger than 40 years, a search for hereditary thrombophilia is generally recommended. Oral anticoagulation after cerebral ischemia is usually recommended for patients with the following disorders: Antithrombin III deficiency, Protein C deficiency, Protein S deficiency, Activated protein C resistance, Plasminogen deficiency/inhibition, Dysfibrinogenemia.

• #2 Stroke Prevention: Practice Essentials, Overview, Primary Prevention of Stroke

  https://emedicine.medscape.com/article/323662-overview

  Atherosclerotic stenosis in the extracranial internal carotid artery or carotid bulb is associated with an increased risk of stroke. […] Sickle cell disease (SCD) typically presents early in life with hemolytic anemia and vaso-occlusive manifestations, including stroke, particularly in children with homozygous disease. […] The Women’s Health Initiative (WHI) showed an increased risk of stroke with CEE therapy, particularly in older subgroups. […] Randomized clinical trials evaluating stroke risk with oral contraceptive (OC) use have not been performed. […] Depression is increasingly being recognized as a possible contributor to stroke. […] Several aspects of diet and nutrition can lead to increased blood pressure, including increased salt or sodium intake, decreased potassium intake, excess weight, and excess alcohol consumption.

• #2 The Stroke Prevention Guidelines Have Been Updated – Here’s What You Need To Know | Henry Ford Health – Detroit, MI

  https://www.henryford.com/blog/2025/02/updated-stroke-guidelines

  In the 2024 AHA guidelines, social determinants of health are highlighted as risk factors that impact a patients likelihood of stroke. Social determinants of health, such as income, housing and environment, play a part in everyones health and wellbeing. Individuals that dont have the same access to resources as others can be at a greater risk for developing serious health conditions such as heart disease and stroke. With the updated guidelines, screenings for these social determinants can help identify patients that are at higher risk, leading to interventions to address these social factors and improve health outcomes. […] Another important addition to the stroke guidelines is the recommendation for sex-specific screenings. Studies show a connection between hormonal changes that women may experience through life and an increased risk for stroke. As a result, additional screening is recommended for some individuals due to increased stroke risk. […] If you already have risk factors for a stroke, make sure to maintain a good relationship with your primary care provider, says Brady. Your provider knows your health history and can work with you to establish prevention measures and help you better understand and manage your risk.

• #2 Prevention | National Institute of Neurological Disorders and Stroke

  https://www.ninds.nih.gov/health-information/stroke/prevention

  Prevention is the number one way to disrupt stroke. The best way to prevent stroke is by lowering your risk. […] Many of these risk factors can be controlled through medications and healthy lifestyle choices. […] Researchers at NINDS predict that, with continued attention to reducing risks of stroke and by using currently available therapies and developing new ones, Americans should be able to prevent 80 percent of all strokes. […] You can help prevent stroke by making lifestyle changes to reduce your risk factors. These include: […] Managing your blood pressure, diabetes, and cholesterol […] Taking care of your heart […] Eating well […] Quitting smoking […] Exercise and being active […] Avoiding drugs and alcohol […] The good news is that you can reduce the risk of having more strokes. Ask your health care provider about the steps you should take and about medications that can help lower your risk.

• #2 AHA/ASA Stroke Secondary Prevention Guideline: Key Points

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2021/06/02/18/08/2021-Guideline-for-the-Prevention-of-Stroke

  Up to 90% of strokes may be preventable by addressing vascular risk factors, including blood pressure control, diet, physical activity, and smoking cessation. Targeting multiple risk factors has additive effects. Despite these data, most stroke survivors have poorly controlled risk factors. […] Secondary prevention strategies should be the same for patients with ischemic stroke and TIA. […] While control of vascular risk factors is important for secondary prevention of all types of ischemic stroke, there are specific strategies used for prevention of various ischemic stroke subtypes. […] For patients who have a stroke while prescribed secondary prevention medications, it is important to determine if patients were taking the medications as prescribed, and evaluate reasons for nonadherence, if applicable, before considering a change in therapy.

• #3 Stroke Prevention and Proactive Care – Brain Injury Association of America

  http://biausa.org/public-affairs/media/stroke-prevention-and-proactive-care

• #3 Blood pressure management to prevent recurrent stroke: current evidence and perspectives | npj Cardiovascular Health

  https://www.nature.com/articles/s44325-024-00021-x

  Hypertension is the leading risk factor for stroke, causing about 60% of cases. Effective blood pressure control is vital for preventing recurrent ischemic strokes, with studies showing mixed results. […] Current evidence states the significant benefits of managing hypertension in stroke survivors, with some studies suggesting that stringent blood pressure control can substantially decrease the likelihood of subsequent strokes and other cardiovascular complications. In summary, blood pressure reduction in the chronic stage of stroke is highly effective in preventing recurrent strokes, protecting cardiovascular health, preserving cognitive function, and reducing overall mortality. […] The ideal blood pressure target for individuals who have experienced a stroke has not yet been established by randomised controlled trials. Current guidelines suggest maintaining a blood pressure consistently below 140/90mmHg for those who have suffered a cerebrovascular event.

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