Toward the end of 2024, the American Heart Association (AHA) shared updates to their stroke guidelines. These guidelines, which serve as the standard for stroke care and prevention in the U.S., had not been updated since 2014 and are intended to help patients understand preventable measures necessary for reducing stroke risk.
“With research showing that more that 80% of strokes are preventable with proper lifestyle modifications, promoting awareness for stroke prevention is a top priority,” says Megan Brady, Stroke Program Manager at Henry Ford Health. “These guidelines have been updated to align with standards already in place for reducing people’s risk for cardiovascular disease and stroke.”
Here, Brady shares insight on the biggest takeaways from these updates and how that influences stroke prevention efforts.
The 8 Essentials For Stroke Prevention
Many of the updates to the stroke guidelines are connected to the AHA’s Life’s Essential 8, a list of lifestyle practices that are tied to a decreased risk for heart disease and stroke. These practices include:
- Eating a healthy diet. For stroke, a Mediterranean-style diet is recommended as the best way to reduce your risk. This means focusing on a whole-food diet that prioritizes lean protein, whole grains, fruits and vegetables.
- Getting more exercise. A sedentary lifestyle increases your chances of stroke. With the updated guidelines comes a focus on screening for sedentary behaviors at doctor visits and offering counseling to patients on the importance of staying active.
- Quitting tobacco use. Tobacco and nicotine products can damage blood vessels – increasing your risk for developing a stroke-causing clot. These risks apply to those using these products directly or those exposed to them second or third hand.
- Getting good sleep. Promoting good sleep is the newest addition this list. Doctors are understanding more about how getting consistent, good-quality sleep helps lower blood pressure and reduces your stroke risk.
- Maintaining a healthy weight. Working to manage your weight can help lower your risk for Type 2 diabetes and obesity.
- Monitoring cholesterol levels. Cholesterol can cause fatty buildups to form in your arteries – narrowing them and increasing your risk for blood vessel blockages to develop.
- Managing blood sugar. High blood sugar, or hyperglycemia, is common in individuals with diabetes. Over time, elevated blood sugar can cause damage to blood vessels.
- Controlling blood pressure. With the stroke guideline updates, healthy blood pressure numbers have been modified. Previously, less than 140/90 was considered a healthy reading. Now, these numbers have been lowered to less than 130/80.
How Social Divides Impact Stroke Risk
In the 2024 AHA guidelines, social determinants of health are highlighted as risk factors that impact a patient’s likelihood of stroke. Social determinants of health, such as income, housing and environment, play a part in everyone’s health and wellbeing. Individuals that don’t have the same access to resources as others can be at a greater risk for developing serious health conditions such as heart disease and stroke. With the updated guidelines, screenings for these social determinants can help identify patients that are at higher risk, leading to interventions to address these social factors and improve health outcomes.
Sex-Specific Stroke Screening Recommendations
Another important addition to the stroke guidelines is the recommendation for sex-specific screenings. Studies show a connection between hormonal changes that women may experience through life and an increased risk for stroke. As a result, additional screening is recommended for some individuals due to increased stroke risk. This could include:
- Pregnant and postpartum individuals, as well as those who had complications with pregnancy
- Those with endometriosis
- Women who have experienced premature (before age 40) or early (before age 45) menopause
- Transgender women taking estrogen for gender affirmation
Reducing Your Stroke Risk
“If you already have risk factors for a stroke, make sure to maintain a good relationship with your primary care provider,” says Brady. “Your provider knows your health history and can work with you to establish prevention measures and help you better understand and manage your risk.”
While stroke prevention is the goal, knowing how to spot the signs of stroke so you can get quick treatment is equally important. Remember F.A.S.T. - Facial drooping, Arm weakness and Slurred speech means it is Time to call 911. Even if you experience symptoms of a stroke that seem to go away, seek immediate care. This could be a warning signs of a transient ischemia attack (TIA) that could precede a larger, more severe stroke if not addressed quickly.
Reviewed by Megan Brady, the Stroke Program Manager at Henry Ford Health.
