Practical NeurologyNew Stroke Prevention Recommendations from AHA/ASA Published

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The American Heart Association and American Stroke Association have released their first update to primary stroke prevention guidelines since 2014. The comprehensive update, published in Stroke, reflects findings from a systematic literature review conducted between May and November 2023. The guidelines incorporate new evidence on risk factor management, including GLP-1 receptor agonists, and introduce specific recommendations for diverse patient populations.

Key Points:

• The guidelines emerge from a multidisciplinary writing group including vascular neurologists, internists, cardiologists, and patient representatives
• Each recommendation carries both a Class of Recommendation (COR) and Level of Evidence (LOE) designation
• New focus areas include GLP-1 receptor agonists for cardiovascular disease risk reduction
• Guidelines address health equity considerations in stroke prevention
• Expanded sex- and gender-specific recommendations cover pregnancy-related hypertension, oral contraceptives, and gender-affirming care

“This guideline is important because new discoveries have been made since the last update 10 years ago. 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.”
– Cheryl D. Bushnell, MD, MHS, FAHA, Professor and Vice Chair of Research of the Department of Neurology at Wake Forest University School of Medicine

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