Despite being a major cause of disability and the fifth most common cause of death in the US, up to 80% of strokes are preventable.
The American Stroke Association (ASA) stated this when it released its revised stroke prevention guidelines in the journal Stroke on Monday.
Cheryl Bushnell, professor of neurology and head of the stroke division at Wake Forest University Health Sciences, emphasized the importance of understanding stroke risk factors and having access to care to manage them. “Key factors like high blood pressure, high cholesterol, and diabetes may require medication to reduce stroke risk,” she explained to Fox News Digital.
Lifestyle choices play a crucial role in prevention. These include weight loss, increased physical activity, reduced sedentary time, adopting a Mediterranean diet, managing sleep apnea, and quitting smoking.
Dr. Bradley Serwer, a cardiologist from Maryland and the chief medical officer of VitalSolution, an Ingenovis Health company that offers anesthesiology and cardiovascular services to hospitals across the country, shared the updates with Fox News Digital.
These guidelines emphasize preventing heart disease. They recommend healthy eating, regular exercise, avoiding tobacco, improving sleep, and managing risk factors like diabetes, high blood pressure, and high cholesterol.
Bushnell described the key modifications as part of an “essential and timely update.”
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Bushnell asserts that since the last set of guidelines, researchers have conducted “groundbreaking clinical trials” on novel drugs that not only treat the target disease, which includes diabetes, obesity, and high cholesterol but also lower the risk of heart disease and stroke.
GLP-1 agonists are a type of medication that helps people with diabetes in two ways. First, they lower blood sugar levels. Second, they can also help people lose weight, which has many benefits.
Together, these strategies can lower the risk of stroke and other diabetes-related problems.
Another option is PCSK9 inhibitors, a type of medication that Bushnell says is very effective at lowering LDL (bad) cholesterol.
She also mentioned that studies have shown these drugs to reduce the risk of stroke.
Physical activity
The American Heart Association has long advised 150 minutes of moderate-intensity exercise, 75 minutes of vigorous-intensity exercise, or a mix of the two to prevent strokes.
According to Bushnell, the new guidelines stress the need to avoid sedentary behavior throughout waking hours in addition to being physically active.
We recommend checking patients for how much time they spend sitting and advising them to reduce sedentary time.
Specialized recommendations for women and other demographics
Additionally, the ASA’s update contains specific recommendations for certain groups.
Bushnell said there are recommendations for reducing high blood pressure and monitoring pregnancy problems in expectant mothers.
The ASA also recommends screening for endometriosis (an inflammatory disease caused by endometrial tissue found outside the uterus), early-onset menopause (before age 45), and premature ovarian failure (very early menopause before age 40) for all women.
We also recommend examining social factors that could potentially negatively impact health, a recommendation that has been updated since the previous guidelines.
There is substantial evidence that negative social determinants of health, such as the inability to afford health insurance, medications, or access to healthcare, can act as barriers to stroke prevention and raise the risk,” explained Bushnell. She also highlighted that the guidelines provide “fairly straightforward strategies” that can significantly reduce stroke risk. “Additionally, following these recommendations not only enhances stroke prevention but also promotes overall brain health,” she stated.
The risk factors for dementia closely align with those for stroke,” Serwer explained. He noted that the updated recommendations reflect the “extensive research and clinical insights” gained over the past decade. “Professional organizations must collaborate in developing multidisciplinary guidelines to enhance patient care,” he added. He also emphasized, “Similar to coronary artery disease and heart attacks, strokes are highly preventable with early intervention.
GLP-1 agonists and stroke risk
In the revised guidelines, the American Heart Association and American Medical Association advise physicians to use Ozempic and other GLP-1 medications to lower the risk of stroke in individuals who have diabetes and an elevated risk of heart disease.
Research from last year suggests that the weight-loss medication Wegovy may reduce the risk of stroke, which forms the basis of the new guidelines. The study found that patients who took the medication and had a body mass index (BMI) high enough to qualify as “overweight” or “obese” experienced a 20% lower risk of heart attack and stroke.
Novo Nordisk, the company that makes the medication, sponsored the research that led to the FDA’s approval of Wegovy in March to reduce the risk of heart attacks, strokes, and other cardiovascular issues.
