Strokes can lead to disabilities such as difficulty speaking, walking, or thinking or even moving hands. (Photo: Getty Images)Monty Rakusen

New guidelines to prevent first stroke that could lead to major disabilities

The American Stroke Association has released new guidelines to prevent first-time strokes, emphasising healthy lifestyle choices and managing risk factors.

by · India Today

In Short

  • With proper prevention, up to 80% of first strokes can be avoided, as per a new guideline
  • Risk factors of stroke include high blood pressure, high cholesterol and obesity
  • Stroke risks for women include high blood pressure during pregnancy or use of oral contraceptives

New clinical guidelines for prevention of the first stroke, known as primary stroke, have been outlined by the American Stroke Association (ASA), a division of the American Heart Association.

A stroke occurs when blood flow to the brain is blocked, either by a clot (ischemic stroke) or a ruptured blood vessel (hemorrhagic stroke), depriving brain cells of oxygen.

The damage is immense as it can lead to disabilities such as difficulty speaking, walking, or thinking or even moving hands.

Most strokes are life-threatening and require immediate medical attention to prevent long-term harm or death.

Published in the ASA's journal Stroke, this guideline mentions the importance of healthy lifestyle choices, regular health screenings, and managing risk factors to prevent strokes.

With proper prevention, up to 80% of first strokes can be avoided.

Most strokes are life-threatening and require immediate medical attention to prevent long-term harm or death. (Photo: Getty Images)

A first stroke refers to the initial occurrence of a stroke in an individual. A person, who has had a first stroke, is more prone to a recurrent or a second stroke. For prevention of a second stroke, lifestyle choices and strict management of risk factors are important.

UNDERSTANDING STROKE AND ITS RISKS

A stroke occurs when blood flow to the brain is blocked, either due to a clot or a ruptured blood vessel. Without the necessary oxygen, the brain becomes damaged, leading to severe disabilities such as problems with movement, speech, and cognitive function.

According to a recent Lancet report, deaths related to strokes are expected to surge from 6.6 million in 2020 to 9.7 million by 2050.

KEY RECOMMENDATIONS

The new guideline focuses on reducing the occurrence of first-time strokes. Cheryl D. Bushnell, professor at Wake Forest University, who led the writing group, stressed the importance of identifying and managing risk factors early.

These risk factors include high blood pressure, high cholesterol, obesity, and elevated blood sugar levels, which can be managed with lifestyle changes and medications, if necessary.

Primary care professionals play a crucial role in promoting brain health by educating patients, conducting regular screenings, and addressing these modifiable risks.

The new guideline focuses on reducing the occurrence of first-time strokes. (Photo: Getty Images)

Medications such as antihypertensives and statins can help in managing high blood pressure and cholesterol, while newer medications, like GLP-1 receptor agonists, are now recommended to reduce cardiovascular disease risk in individuals with obesity or type 2 diabetes.

THE ROLE OF A HEALTHY LIFESTYLE

Healthy lifestyle habits form the foundation of stroke prevention. The American Stroke Association outlined key behaviours through its 'Life's Essential 8' metrics:

  • Eating a nutritious diet
  • Being physically active
  • Avoiding tobacco
  • Maintaining healthy weight
  • Managing cholesterol
  • Managing blood pressure levels
  • Ensuring good sleep
  • Controlling blood sugar levels

Adults are encouraged to follow a Mediterranean diet, which includes olive oil and nuts, and engage in regular physical activity, such as 150 minutes of moderate exercise per week.

Physical activity improves several health indicators that reduce stroke risk, such as blood pressure, cholesterol, and weight.

ADDRESSING HEALTH INEQUITIES

The guideline also acknowledged the role social factors play in stroke risk. Factors like education, access to care, and economic stability affect a person's overall health and ability to prevent strokes.

Healthcare providers have been urged to offer resources to patients to address food insecurity, housing instability, and other social challenges that can hinder stroke prevention efforts.

RECOMMENDATIONS FOR WOMEN

Women face certain stroke risks, such as high blood pressure during pregnancy or use of oral contraceptives, which require special attention.

The guideline also acknowledged the role social factors play in stroke risk. (Photo: Getty Images)

Health professionals should screen women for these conditions to reduce their stroke risk. Gender-diverse individuals on estrogen therapy may have an increased risk and should receive personalised care to manage their stroke risk.

A FOCUS ON EARLY PREVENTION

The updated guideline stressed early prevention and risk assessment through tools like the PREVENT risk calculator, which can predict cardiovascular disease and stroke risk as early as age 30.

By adopting these strategies, individuals can take proactive steps to avoid strokes and related conditions such as dementia.

"This updated guideline is intended to be a resource for clinicians to use to guide various prevention strategies for individuals with no history of stroke," as per the researchers.