stroke

New Stroke Guidelines Highlight Nutrition

The American Heart Association and American Stroke Association have released updated guidelines for the prevention of recurrent stroke in patients with stroke or transient ischemic attack.

These guidelines, last updated in 2011 but frequently reviewed to keep pace with current research, include new sections on nutrition and sleep apnea, as well as revise sections on hypertension, dyslipidemia, diabetes, carotid stenosis, and atrial fibrillation.
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The new guidelines on nutrition state:

  • It is reasonable to conduct a nutritional assessment to look for signs of overnutrition or undernutrition; those with signs of undernutrition should be referred for nutritional counseling.
  • The use of routine supplementation with a single vitamin or vitamin combinations is not recommended.
  • It is reasonable to recommend reduction of sodium intake to less than 2.4 grams per day, or even lower to less than 1.5 grams per day.
  • It also is reasonable to recommend adherence to a Mediterranean-type diet of vegetables, fruits, whole grains, low-fat dairy, poultry, fish, legumes, olive oil, and nuts, as well as limit sweets and red meats.

Revisions include:

  • Clarifications added to the hypertension section on when to initiate antihypertensive therapy.
  • Revisions to dyslipidemia making it consistent with the cholesterol guideline released last fall by the ACC and AHA.
  • Greater emphasis on lifestyle changes was included.
  • Atrial fibrillation, carotid stenosis, and prosthetic heart valve sections were made consistent with recently published ACCP guidelines. 

The complete guidelines are available in the May issue of Stroke.

–Michael Potts

Kernan WN, Ovbiagele B, Black HR, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014 May 14 [epub ahead of print] doi: 10.1161/​STR.0000000000000024