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Seemant Chaturvedi, MD, Stewart J. Greenebaum Endowed Professor of Stroke Neurology and Director of the University of Maryland Medical System's stroke program and Steven Kittner, MD, MPH, Professor of Neurology at University of Maryland School of Medicine and Vice-Chair for Research in the Neurology Department, co-authored new guidelines for the prevention of stroke and transient ischemic attack (TIA) in people who have already suffered a stroke.

In collaboration with the American Heart Association/American Stroke Association (AHA/ASA), these widely influential guidelines aim to drive secondary stroke prevention efforts across the United States and around the world. This new guidance contains several important changes to approaches in secondary stroke prevention including:

  • A more holistic approach: Instead of treating only one risk factor, such as high blood pressure, the new guidelines recommend an intensive medical management approach that combines both medication and lifestyle factors.
  • Emphasis on lifestyle: The new guidelines highlight the importance of lifestyle factors such as dietary change and physical activity. Low-salt and/or Mediterranean diets are recommended.
  • Focus on treating: AFib Atrial fibrillation (AFib) remains a leading cause of stroke, yet it continues to be under-treated. Anticoagulants are very effective in stroke prevention for AFib patients but are currently used in only 40 to 50 percent of eligible patients. The updated guidance encourages AFib treatment for all eligible patients.
  • Inclusion of triglycerides: Previous guidelines have focused on the treatment of dyslipidemia, which continues to be very important. The new guideline includes the first recommendation for treatment of high triglycerides as well.
  • Consideration of diabetes medications: Several new medications for diabetes have now been shown to have benefits for reducing vascular disease. For the first time, these guidelines recommend consideration of these medications for secondary stroke prevention.

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