Hemorrhagic stroke primary prevention: Difference between revisions

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==2014 AHA/ASA Guidelines for the Primary Prevention of Stroke<ref name=ASA/AHA-Primary-Prevention-Guid> 2014 AHA/ASA Guidelines for the Primary Prevention of Stroke http://stroke.ahajournals.org/content/early/2014/10/28/STR.00000000000000467 Accessed on November 17, 2016</ref>==
   
===Genetic Factors: Recommendations===
*Noninvasive screening for unruptured intracranial aneurysms may be considered in patients with  
{|class="wikitable"
**Cervical [[fibromuscular dysplasia]]
|-
**≥2 first-degree relatives with [[SAH]] or intracranial aneurysms  
|colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (Harm)
**[[PKD|ADPKD]] and ≥1 relatives with [[PKD|ADPKD]] and [[SAH]] or intracranial aneurysm
|-
*Life style modifications such as:
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' Genetic screening of the general population for prevention of a first stroke is not recommended ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
**Increased physical activity in obese or over weight patients to maintain healthy weight
|-
**Reduced intake of [[sodium]] and increased intake of [[potassium]]  
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''2.''' Screening of patients at risk for myopathy in the setting of statin use is not recommended when considering initiation of [[statin]] therapy at this time''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
**A diet that is rich in fruits and vegetables
|-
**Smoking cessation and decreased alcohal intake
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''3.''' Noninvasive screening for unruptured intracranial aneurysms in patients with >2 first-degree relatives with SAH or intracranial aneurysms might be reasonable ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
**Referral to an appropriate therapeutic program is reasonable for patients who abuse drugs
|-
*Treatment of hypertension
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''4.'''Universal screening for intracranial aneurysms in carriers of mutations for Mendelian disorders associated with [[aneurysm]] is not recommended ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|-
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''5.''' Dosing with [[vitamin K antagonists]] on the basis of [[pharmacogenetics]] is not recommended at this time''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|}


{|class="wikitable"
For more information about primary prevention of stroke, click [[AHA/ASA guideline recommendations for prevention of stroke|here]].
|-
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Obtaining a family history can be useful to help identify persons who may be at increased risk of stroke ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki>
|}
 
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Referral for genetic counseling may be considered for patients with rare genetic causes of stroke ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' Treatment for certain genetic conditions that pre- dispose to stroke (eg, Fabry disease and enzyme replacement therapy) might be reasonable but has not been shown to reduce risk of stroke, and its effectiveness is unknown  ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.''' Noninvasive screening for unruptured intracranial aneurysms in patients with [[ADPKD]] and >1 relatives with ADPKD and [[SAH]] or intracranial aneurysm may be considered''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''4.''' Noninvasive screening for unruptured intracranial aneurysms in patients with cervical [[fibromuscular dysplasia]] may be considered''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|}


==References==
==References==

Revision as of 02:15, 21 November 2016

Hemorrhagic stroke Microchapters

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AHA/ASA Guidelines for the Management of Spontaneous Intracerebral Hemorrhage (2015)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Primary prevention

Primary prevention of hemorrhagic stroke is mainly aimed at treatment and modifcation of risk factors which are directly associated with increased occurence of hemorrhagic stroke. Effective measures for primary prevention of stroke include:


  • Noninvasive screening for unruptured intracranial aneurysms may be considered in patients with
  • Life style modifications such as:
    • Increased physical activity in obese or over weight patients to maintain healthy weight
    • Reduced intake of sodium and increased intake of potassium
    • A diet that is rich in fruits and vegetables
    • Smoking cessation and decreased alcohal intake
    • Referral to an appropriate therapeutic program is reasonable for patients who abuse drugs
  • Treatment of hypertension

For more information about primary prevention of stroke, click here.

References


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