New Stroke Prevention Guidelines: A Quick and Easy Guide

Helmi L. Lutsep, MD; Bret S. Stetka, MD


January 16, 2015

In This Article

Physical Inactivity

The Basics

Physical activity is recommended

Healthy adults: moderate- to vigorous-intensity aerobic activity at least 40 minutes per day, 3-4 days per week

The Bottom Line: Many observational studies have shown the benefit of exercise in the reduction of stroke risk. People should seek out activities they enjoy; even walking, for example, has been shown to reduce the risk for stroke. The time spent exercising can be broken up for those who find it difficult to exercise for the full recommended times.


The Basics

Lifestyle interventions High 10-year cardiovascular risk: Initiate statin therapy

Low high-density lipoprotein cholesterol or high lipoprotein (Lp) (a): Consider niacin, although efficacy in stroke prevention not established

Hypertriglyceridemia: Consider fibric acid derivatives, although efficacy in stroke prevention not established

If statin-intolerant: Consider other lipid-lowering therapies, although efficacy in stroke prevention not established

The Bottom Line: Statin therapy is indicated in patients with higher 10-year cardiovascular risks, as determined by a cardiovascular risk calculator, to reduce the chance of atherosclerotic stroke. Since the current guidelines were published, additional data have also emerged for ezetimibe, an agent that prevents reabsorption of cholesterol in the intestine, in the prevention of heart disease and stroke. In the IMPROVE-IT trial,[2] a combination of ezetimibe and simvastatin prevented more heart- and stroke-related events than simvastatin alone. Ezetimibe may provide an option for statin-intolerant patients.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: