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Recent updates to U.S. guidelines for stroke prevention have introduced vital new recommendations, according to a publication from the American Stroke Association (ASA). The publication, featured in the journal Stroke, presents the first updated guidelines since 2014. Strokes are the fifth-leading cause of death in the United States and the primary cause of disability; however, the ASA asserts that up to 80% of strokes are preventable.

Dr. Cheryl Bushnell, a professor of neurology and chief of the stroke division at Wake Forest University Health Sciences, emphasized the importance of recognizing risk factors and securing adequate treatment, particularly for conditions such as high blood pressure, high cholesterol, and diabetes. She highlighted that lifestyle changes, including weight loss, increased physical activity, and dietary modifications such as adopting a Mediterranean diet, play a crucial role in stroke prevention.

One of the notable updates discussed involves new medications derived from "groundbreaking clinical trials" that can better manage diseases like diabetes, obesity, and high cholesterol, further reducing the risk of stroke and heart disease. For instance, glucagon-like peptide (GLP-1) receptor agonists have shown remarkable success in reducing blood sugar levels and facilitating significant weight loss in diabetes patients. These medications also contribute to lowering the risk of stroke and other related complications. Additionally, PCSK9 inhibitors, another class of drugs, are noted for their effectiveness in lowering LDL (bad) cholesterol and subsequently reducing stroke risk.

Beyond medical treatments, the updated guidelines put a stronger emphasis on physical activity. Historically, the ASA recommended 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity weekly. The new guidelines not only maintain these recommendations but also stress the importance of minimizing sedentary behavior during waking hours. This involves new recommendations for screening and advising patients to steer clear of prolonged inactivity.

The update also extends to specific demographic groups. Guidelines now include recommendations for pregnant women to address high blood pressure and monitor for pregnancy complications. For all women, screening for premature ovarian failure, early-onset menopause (before age 45), and endometriosis is advised. Furthermore, the guidelines suggest screening for adverse social determinants of health, marking another significant addition from prior recommendations.

Overall, these updated ASA guidelines represent a comprehensive effort to reduce the prevalence and impact of strokes through both medical innovations and practical lifestyle adjustments.