Each year, hundreds of thousands of people in the United States suffer a stroke, often leading to severe disability and death. In an effort to reduce these numbers, the American Heart Association (AHA) and American Stroke Association (ASA) recently released updated guidelines aimed at helping health care providers prevent strokes before they occur. The new 2024 Guidelines for Primary Stroke Prevention integrates recent research findings, including gender-specific risk assessments and lifestyle interventions, to help people control modifiable risk factors associated with stroke. It has been.
Understand the updated guidelines
The 2024 guidelines emphasize that stroke prevention is primarily achievable through lifestyle and medical changes. The AHA and ASA expanded on the original 2014 guidelines with a focus on making recommendations based on research conducted over the past decade. The guidelines focus on improving individual health rather than systemic interventions and cover personal changes within the individual’s control, such as diet, exercise, and blood pressure management.
New additions address lesser-known risk factors such as migraine and endometriosis. Traditionally overlooked in stroke prevention, these symptoms show a correlation with increased stroke risk, highlighting the need for recognition and screening. Additionally, the guidelines consider risks related to hormone-related issues, noting that people who experience early menopause or use high-estrogen contraceptives may have higher rates of stroke. I am.
Social factors and stroke risk
Although the guidelines primarily focus on individual lifestyle changes, they also acknowledge the role of social determinants in stroke risk. Access to healthy food, safe neighborhoods, and health insurance coverage are all factors that influence an individual’s health and likelihood of stroke. Although these factors require broad and systematic solutions, the guidelines encourage health care providers to screen for social issues that may pose barriers to stroke prevention. By identifying these factors, health professionals can help individuals make adjustments or seek support to overcome these challenges.
Recognizing new stroke risk factors
One of the key advances in the 2024 guidelines is the inclusion of migraine and endometriosis as new risk factors. Because migraines may indicate an increased chance of stroke, it is now recommended that people who have frequent migraines work with their doctors to manage their vascular risk factors. Similarly, patients with endometriosis are at increased risk of stroke, and screening for this disease may allow for early intervention to reduce the associated risks.
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For women, especially those who are pregnant or have just given birth, the guidelines emphasize the importance of controlling blood pressure. If your blood pressure level is above 160/110 in the weeks after birth, you are warned that you are at risk for a stroke and your health care provider is advised to closely monitor your newborn. The guidelines further warn against high-estrogen hormonal contraceptives and recommend instead reducing the dose to avoid increased blood clotting that can lead to stroke.
Lifestyle changes are the core of prevention
AHA and ASA recommendations emphasize the influence of lifestyle in stroke prevention. The updated guidelines align with the AHA’s “Life’s Essential 8” framework, which includes diet, physical activity, blood pressure control, and smoking as fundamental components of heart and brain health. For example, the Mediterranean diet has been praised for its effectiveness in preventing strokes, and salt replacements may help people with high blood pressure.
Physical activity is also an important factor. Adults are recommended to do 150 minutes of moderate-intensity exercise or 75 minutes of vigorous exercise each week to lower their risk of stroke. Reducing sedentary behavior has also been noted to be important for brain and cardiovascular health. Diabetes management is also an important aspect, as high blood sugar levels can cause blood vessel damage and increase the chance of stroke. The guidelines recommend regular screening for people with diabetes and, if necessary, the use of GLP-1 receptor agonists to help control blood sugar.
Additional recommendations regarding blood pressure and tobacco use
Blood pressure management remains an important area of focus. The guidelines recommend regular check-ups, lifestyle adjustments, and appropriate medications to help individuals manage high blood pressure. For patients who require medication, combining two or more antihypertensive drugs may reduce the risk of stroke.
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Addressing tobacco use is also an important recommendation. The guidelines call on health care providers to screen patients for smoking, encourage non-smokers to avoid smoking, and strongly encourage current smokers to quit. Smoking damages blood vessels and promotes plaque buildup in arteries, increasing the risk of stroke. Therefore, quitting smoking is one of the most effective changes a person can make to prevent stroke.
Looking ahead: Areas for further research
Despite the comprehensive nature of the 2024 Guidelines, the authors acknowledge that there is still much to learn. Further research is needed to fully understand the relationship between social determinants and stroke risk and establish evidence-backed approaches for screening in areas such as hormonal contraception, endometriosis, and early menopause. is. Additional research is also needed to investigate the unique stroke risks faced by transgender individuals receiving hormone therapy.
Additionally, the guidelines do not cover all conditions associated with stroke risk, such as heart valve disease, which are covered in separate medical documents. Recognizing these gaps, guideline authors call for further research on specific high-risk conditions to continue to improve stroke prevention strategies.
The future of improving stroke prevention
The 2024 guidelines highlight the significant potential for individuals to reduce their stroke risk through informed lifestyle choices and medical interventions. As health care providers adopt these latest recommendations, people at high risk for stroke can take concrete steps to protect their health. AHA and ASA’s data-driven approach encourages active management of risk factors and targets specialized monitoring for groups such as pregnant people and people with specific hormonal profiles. Ultimately, this updated guidance serves as a valuable resource for clinicians and patients alike, aiming to reduce the incidence and impact of stroke on individuals and their communities.
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