The Stroke Council of the American Heart Association (AHA) recently updated its 1999 strokeprevention guidelines. The guidelines are evidencebased, and recommendations are given a grade based on the strength of the evidence that supports them. The new recommendations suggest that transient ischemic attack (TIA) and stroke be treated in an equally aggressive manner. The authors also recommend an approach that reduces the risk of all vascular events. Recommendations regarding management of risk factors related to comorbidities (hypertension, diabetes, and lipids) and lifestyle issues (smoking, physical activity, and alcohol) are included as well.

The new guidelines issue the strongest recommendations for the following:

• Antiplatelet therapy for noncardioembolic stroke or TIA
• Warfarin therapy for atrial fibrillation
• Carotid endarterectomy for large artery atherosclerosis
• Statin therapy
• Antihypertensive therapy
• Diabetes control

The updated guidelines can be accessed on the AHA's Web site, www.americanheart.org.

Dr. Garrett is a clinical pharmacist practitioner at Cornerstone Health Care in High Point, NC.