Bushnell C, Kernan WN, Sharrief AZ, et al. 2024 Guideline for the Primary Prevention of Stroke: A Guideline From the American Heart Association/American Stroke Association. Stroke. 2024 Dec;55(12):e344-e424. doi: 10.1161/STR.0000000000000475. Epub 2024 Oct 21.
Abstract

AIM: The "2024 Guideline for the Primary Prevention of Stroke" replaces the 2014 "Guidelines for the Primary Prevention of Stroke." This updated guideline is intended to be a resource for clinicians to use to guide various prevention strategies for individuals with no history of stroke.

METHODS: A comprehensive search for literature published since the 2014 guideline; derived from research involving human participants published in English; and indexed in MEDLINE, PubMed, Cochrane Library, and other selected and relevant databases was conducted between May and November 2023. Other documents on related subject matter previously published by the American Heart Association were also reviewed.

STRUCTURE: Ischemic and hemorrhagic strokes lead to significant disability but, most important, are preventable. The 2024 primary prevention of stroke guideline provides recommendations based on current evidence for strategies to prevent stroke throughout the life span. These recommendations align with the American Heart Association's Life's Essential 8 for optimizing cardiovascular and brain health, in addition to preventing incident stroke. We also have added sex-specific recommendations for screening and prevention of stroke, which are new compared with the 2014 guideline. Many recommendations for similar risk factor prevention were updated, new topics were reviewed, and recommendations were created when supported by sufficient-quality published data.

Ratings by Clinicians (at least 3 per Specialty)
Specialty Score
Public Health
Neurology
Family Medicine (FM)/General Practice (GP)
General Internal Medicine-Primary Care(US)
Comments from MORE raters

Neurology rater

This guideline pointed out that up to 80% of strokes are preventable. so they advocate for better primary prevention of stroke, including better screening and lifestyle changes. They recommend drugs not only to treat the target disease (diabetes/obesity and high cholesterol), but also to reduce the risk for stroke and heart disease. This is the case of GLP-1) receptor agonists that significantly improve type 2 diabetes and weight loss, and reduce the risk for cardiovascular disease. At least two drugs are needed to lower BP. This guideline emphasizes women's health.