Controlling blood pressure, lifestyle changes could help prevent subsequent strokes

Stroke survivors should control their blood pressure, cholesterol and weight and do moderate physical activity regularly to avoid having another stroke.

According to an American Heart Association/American Stroke Association scientific statement, they should also receive other evidence-based therapy specific to their individual health, which may include aspirin therapy or a surgical procedure to keep neck arteries open.

"A vast amount of new research is revealing new and improved ways to protect patients with an ischemic stroke or transient ischemic attack from having recurrent events and further brain damage," Walter Kernan, M.D., lead author and chair of the guideline writing group and professor of medicine at Yale University School of Medicine in New Haven, Connecticut said.

Treating high blood pressure is possibly most important for secondary prevention of ischemic stroke, according to the statement. About 70 percent of people who have had a recent ischemic stroke also have high blood pressure.

The statement notes that intensive cholesterol-lowering therapy is also important for survivors whose stroke was caused by hardened arteries.

However, the association no longer recommends niacin or fibrate drugs to raise good cholesterol, due to sparse data establishing their effectiveness at reducing secondary stroke risk.

It's also good for stroke/TIA survivors capable of engaging in physical activity to have three to four sessions per week of moderate-vigorous intensity aerobic physical exercise such as walking briskly or riding a bike, according to the statement.

The statement, "Guidelines for the Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack (TIA)," is published in the American Heart Association journal Stroke.