According to the American Heart Association/American Stroke Association’s scientific statement entitled “Guidelines for the Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack (TIA),” controlling blood pressure, cholesterol, and arrhythmias are important to stroke survivors avoiding another stroke.

The statement highlighted that treating high blood pressure is possibly most important regarding secondary prevention of ischemic stroke. The association no longer recommends the use of niacin or fibrate drugs to raise good cholesterol due to lack of data supporting secondary stroke risk reduction. In addition, 3–4 sessions of moderate-vigorous physical activity (eg, biking, briskly walking per week were encouraged. Stroke survivors should also receive necessary evidence-based therapy tailored to their individual health, which may include aspirin therapy or a surgery to keep their neck arteries open.

Compared to the last guideline update in 2011, the association has added 4 sections: nutrition, sleep apnea, aortic arch atherosclerosis, and prediabetes.

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Some of the new recommendations include:

  • Screening stroke and TIA survivors for diabetes and obesity
  • Possible screening for sleep apnea
  • Possible nutritional assessment
  • 30-day monitoring for irregular heart beat (eg, atrial fibrillation) for those who had a stroke of unknown cause
  • Anticoagulants in specific situations
  • Following a Mediterranean-type diet that emphasizes vegetables, fruits, whole grains and includes low-fat dairy, poultry, fish, legumes and nuts and limits sweets and red meat

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