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Updated Stroke Prevention Guidelines

Updated Stroke Prevention Guidelines

The American Heart Association and American Stroke Association (AHA/ASA) have updated guidelines on primary stroke prevention based on comprehensive and timely evidence from clinical investigations and research trials. Recommendations are included for controlling risk factors, using interventional approaches to atherosclerotic disease, and antithrombotic treatments for preventing stroke. The guidelines were published in Stroke and are available for free online at http://stroke.ahajournals.org. “One of the most important changes in the AHA/ASA guidelines is that newer anticoagulants can be used as alternatives to warfarin to prevent stroke in patients with atrial fibrillation (AF),” says James F. Meschia, MD, FAHA, who chaired the AHA/ASA committee that developed the recommendations. The guidelines note that although some of the new AF drugs are more expensive, they require less ongoing monitoring and therefore represent reasonable options for patients. Another key recommendation from the guidelines is that clinicians are urged to use of statins, along with diet and exercise, to help lower the stroke risk in patients at high risk for experiencing a stroke within the next 10 years. “In addition, the CHA2DS2-VASc is recommended for stratifying the risk for stroke,” says Dr. Meschia. “Patients with a score of 0 on the CHA2DS2-VASc do not require anticoagulants, but those with a score of 2 or higher should receive these therapies.” He adds that patients with a score of 1 on CHA2DS2-VASc can be considered for anticoagulants.   Women & Stroke According to the AHA/ASA, women have higher stroke risks if they are pregnant, use oral contraceptives, use hormone replacement therapy, have migraines, and/or have depression. The guidelines recognize the different risk factors women face throughout their...
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