Highlighting More Risk Factors and Treatments in Updated Stroke Prevention Guidelines: Cheryl D. Bushnell, MD, MHS, FAHA

WATCH TIME: 6 minutes

"Getting up and walking or standing for 10 minutes every hour can significantly reduce the risk of poor outcomes."

Research shows that a stroke is defined as when cerebral blood flow is disrupted because of either the occlusion of a blood vessel by a thrombus or embolus or by vessel rupture, which leads to hemorrhage. Thus, this interruption results in cerebral hypoxia, impairing neuronal function and potentially causing irreversible brain injury. Stroke is known as a major cause of morbidity, often resulting in cognitive impairment, dysphasia, motor deficits, and functional limitations in activities of daily living. In the United States, stroke is the fifth leading cause of mortality, accounting for nearly 160,000 deaths annually, yet up to 80% of the more than 600,000 first strokes each year are considered preventable with appropriate interventions.

A newly published clinical guideline from the American Stroke Association, replacing the previous 2014 version,offered evidence-based recommendations for strategies for stroke prevention.^1,2 The newer guideline is intended to be a resource for providers in the implementation of various prevention strategies for patients who do not have a prior history of stroke. In this guideline, a volunteer writing group conducted a literature search of evidence from multiple databases and reviewed other previously published documents related to the topic. Based on the reviewed evidence, the authors identified key recommendations for preventing incident stroke which included regular health screenings, recognizing risk factors, lifestyle interventions and medications, when needed.

Following the publication, Cheryl D. Bushnell, MD, MHS, FAHA, chair of the guideline writing group, sat down with NeurologyLive^® to further discuss the clinical implications of the updated guideline. During the conversation, she talked about how the glucagon-like peptide-1 (GLP-1) receptor agonists contribute to reducing stroke risk in patients with diabetes. Bushnell, professor and vice chair of research in the department of neurology at Wake Forest University School of Medicine, also spoke about the new recommendations for sedentary behavior and how they impact stroke prevention. Toward the end of the interview, she explained how women's specific risk factors, such as early menopause or pregnancy-related conditions, influenced the stroke prevention guideline.

REFERENCES
1. Bushnell C, Kernan WN, Sharrief AZ, et al. 2024 Guideline for the Primary Prevention of Stroke: A Guideline From the American Heart Association/American Stroke Association. Stroke. Published online October 21, 2024. doi:10.1161/STR.0000000000000475
2. New guideline: Preventing a first stroke may be possible with screening, lifestyle changes. News Release. American Heart Association. Published October 21, 2024. Accessed October 22, 2024. https://newsroom.heart.org/news/new-guideline-preventing-a-first-stroke-may-be-possible-with-screening-lifestyle-changes