Stroke

New stroke prevention guideline highlights GLP-1 RAs and women’s unique risk factors

October 25, 2024

The American Heart Association/American Stroke Association’s 2024 Guideline for the Primary Prevention of Stroke, which replaces its 2014 guideline, was released on October 21. New recommendations include use of GLP-1 receptor agonists (GLP-1 RAs), diet and lifestyle changes, and sex-specific suggestions for stroke prevention.

5 Key Takeaways

• GLP-1 RAs. GLP-1 RAs received a class 1a recommendation for reducing stroke in patients with diabetes and high CV risk or established CV disease.
• Physical activity. Historically, the ASA recommended 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity per week. The updated guideline now emphasizes screening for sedentary behavior and counseling patients to avoid prolonged inactivity.
• Specific guidance for women. Physicians should manage hypertension during pregnancy and within 6 weeks of delivery to mitigate the risk of maternal intracerebral hemorrhage. Additionally, screening for stroke risk factors such as the use of oral contraceptives, premature ovarian failure, early-onset menopause, and endometriosis is recommended for all women.
• Social determinants of health. At-risk stroke patients should be screened for social determinants of health (e.g, economic stability, education, discrimination) that may impact overall health and contribute to inequities in care.
• Estrogen supplementation. Estrogen taken by gender-diverse individuals increases risk of stroke. Therefore, the guideline advises evaluating and modifying risk factors to reduce stroke risk in these individuals.

Source:

Bushnell C, et al. (2024, October 21). Stroke. 2024 Guideline for the Primary Prevention of Stroke: A Guideline From the American Heart Association/American Stroke Association. https://pubmed.ncbi.nlm.nih.gov/39429201/