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Updated Guidelines for Preventing Recurrent Stroke — Physician’s First Watch
Updated Guidelines for Preventing Recurrent Stroke
By Kelly Young
The American Heart Association and the American Stroke Association have released updated guidelines for preventing recurrent stroke in patients who've experienced a stroke or transient ischemic attack.
Here are a few of the changes from the groups' 2011 guidelines:
Systolic blood pressure below 140 mm Hg and diastolic pressure below 90 mm Hg are reasonable goals.
Vitamin K antagonist therapy, apixaban, and dabigatran are indicated to prevent recurrent stroke in patients who have nonvalvular atrial fibrillation, while rivaroxaban is considered a reasonable option.
For patients over age 70, carotid endarterectomy may have better outcomes than carotid angioplasty with stenting. In younger patients, the two approaches are similar in their risks for perioperative complications and long-term ipsilateral stroke.
Additional recommendations on medical and surgical management are included.