New Stroke Prevention Recommendations from AHA/ASA Published

The American Heart Association and American Stroke Association (AHA/ASA) have published a new set of recommendations for the prevention of stroke. These new recommendations, which are published in the journal Stroke, are intended to serve as a resource for clinicians to integrate into their practice, providing strategies for stroke prevention for individuals with no history of the condition. This is the first update to AHA/ASA issued recommendations on this topic since the 2014 “Guideline for the Primary Prevention of Stroke”

The publication, which is titled “2024 Guideline for the Primary Prevention of Stroke” is the result of a comprehensive literature review conducted between May and November 2023, based on clinical research published in English since 2014 involving human participants. The literature review was performed by the 2024 Primary Prevention of Stroke Guideline Writing Group, consisting of vascular neurologists, internists, cardiologists, and other professionals with expertise in stroke care, as well as 2 patient representatives. Each recommendation is designated with a Class of Recommendation (COR) indicating the recommendation’s strength and Level of Evidence (LOE) indicating the strength of the scientific evidence supporting the intervention.

Topics included in the new recommendations include:

• Identifying and managing risk factors for stroke
• The use of glucagonlike protein-1 (GLP-1) receptor agonists to reduce risk of cardiovascular disease
• Lifestyle behaviors that can impact stroke risk
• The relationship between health equity and stroke risk

The publication also includes new sex- and gender-specific recommendations pertaining to the impact of high blood pressure during pregnancy, the use of oral contraceptives, pregnancy complications, and specific considerations for transgender individuals or those taking estrogen as part of their gender-affirming care.

“This guideline is important because new discoveries have been made since the last update 10 years ago,” said Cheryl D. Bushnell, MD, MHS, FAHA, Professor and Vice Chair of Research of the Department of Neurology at Wake Forest University School of medicine and member of the guideline’s writing group. “Understanding which people are at increased risk of a first stroke and providing support to preserve heart and brain health can help prevent a first stroke.”