AMERICAN HEART ASSOCIATION ISSUES NEW STROKE-PREVENTION GUIDELINES

The Stroke Council ofthe American Heart Association(AHA) recentlyupdated its 1999 strokepreventionguidelines. Theguidelines are evidencebased,and recommendationsare given a gradebased on the strength ofthe evidence that supports them. The newrecommendations suggest that transientischemic attack (TIA) and stroke be treatedin an equally aggressive manner. The authorsalso recommend an approach that reducesthe risk of all vascular events. Recommendationsregarding management of riskfactors related to comorbidities (hypertension,diabetes, and lipids) and lifestyle issues(smoking, physical activity, and alcohol) areincluded as well.

The new guidelines issue the strongest recommendationsfor the following:

• Antiplatelet therapy for noncardioembolicstroke or TIA
• Warfarin therapy for atrial fibrillation
• Carotid endarterectomy for large arteryatherosclerosis
• Statin therapy
• Antihypertensive therapy
• Diabetes control

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

Dr. Garrett is a clinical pharmacistpractitioner at Cornerstone Health Carein High Point, NC.