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New Guidelines for Stroke Prevention

American Stroke Association Highlights Ways People Can Lower Their Risk of Stroke
WebMD Health News
Reviewed by Louise Chang, MD

May 4, 2006 -- Today, tomorrow, and every day this year, roughly 1,900 strokes will be suffered by people in the U.S.

After heart disease and cancer, strokes are responsible for more American deaths than any other medical condition, but experts say much could be done to change this.

Guidelines released today by the American StrokeAssociation highlight some well-established and less well-known risk factors for stroke, as well as measures people can take to lower their risk.

"We are making some progress, but we still have a big mountain to climb," says Larry B. Goldstein, MD, who led the guidelines committee. "People are more aware of stroke than they used to be. But far too many people ignore or don't recognize the symptoms of stroke and delay seeking treatment."

Who Is at Risk

Low birth weight was recognized for the first time as a possible risk factor for stroke, based on recent studies suggesting a doubling of risk among adults who weighed less than 5.5 pounds at birth compared with those who weighed 8.8 pounds or more. The reason for this is unclear, and this association does not mean that low birth weight causes stroke.

Other well established, nonmodifiable stroke risk factors include age, sex, race or ethnic background, and family history. Elderly people, men, blacks, and people with a family history of stroke tend to have a higher than average risk.

The guidelines call for very aggressive stroke screening and prevention efforts for children and adults with sickle cell disease. About 10% of children with sickle cell will have had a stroke by the time they reach adulthood.

The committee report also called on doctors to assess their patients' stroke risk using established tools.

Patients who know they are at risk for having a stroke tend to be more motivated to make lifestyle changes and take their medication than patients who are simply told they have cardiovascular disease, Goldstein says.

"We know that people greatly fear the consequences of stroke, such as being unable to talk and understand, being unable to care for yourself, and being unable move one side of your body," he tells WebMD.

Lowering Stroke Risk

The new report reiterated some well-known steps that people can take to lower their stroke risk, including:

  • Knowing your blood pressure and keeping high blood pressure under control
  • Not smoking and avoiding exposure to secondhand smoke
  • Getting regular physical exercise
  • Aggressively treating disorders that increase stroke risk, such as diabetes, irregular heartbeat, carotid artery disease, and heart failure
  • Treating diabetes patients with statins to lower "bad" cholesterol
  • Increasing potassium in the diet to at least 4.7 grams a day and reducing sodium intake to 2.3 grams or less to help lower blood pressure in people with hypertension
  • A referral to be considered for genetic counseling for people with rare genetic causes of stroke

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