Health
New stroke prevention guidelines released by American Stroke Association
Strokes are the fifth-leading cause of death in the United States, and the leading cause of disability — but up to 80% of them are preventable.
That’s according to the American Stroke Association (ASA), which on Monday published its updated guidelines for stroke prevention in the journal Stroke.
This was the first update since its 2014 set of guidelines.
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“The key to preventing stroke is to understand what the risk factors are and have access to care to address the ones that may require medications, such as high blood pressure, high cholesterol and diabetes,” study author Cheryl Bushnell, professor of neurology and stroke division chief in the Department of Neurology at Wake Forest University Health Sciences in Winston-Salem, told Fox News Digital.
Strokes are the fifth-leading cause of death in the United States, and the leading cause of disability — but up to 80% of them are preventable. (iStock)
“Other prevention approaches are lifestyle changes, such as weight loss, being physically active, avoiding sitting all day during waking hours, eating a healthy diet (such as the Mediterranean diet), treating sleep apnea (which prevents optimal sleep at night) and smoking cessation.”
Dr. Bradley Serwer, a Maryland-based cardiologist and chief medical officer at VitalSolution, an Ingenovis Health company that offers cardiovascular and anesthesiology services to hospitals nationwide, commented on the updates to Fox News Digital.
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“These guidelines have several unique takeaway points, but focus on primary prevention with established strategies focused on better diet, exercise, avoiding tobacco, improving sleep quality and treating known risk factors such as diabetes, hypertension and hypercholesterolemia,” he said.
Bushnell recapped the main changes in what she calls an “important and timely update.”
New medications
Since the last set of guidelines, there have been “groundbreaking clinical trials” into new medications that not only treat the target disease — such as diabetes, obesity and high cholesterol — but also reduce the risk of stroke and heart disease, according to Bushnell.
Stroke prevention practices are closely tied to Life’s Essential 8, the American Heart Association’s eight elements that are deemed essential for cardiovascular health. (American Heart Association)
“For example, the glucagon-like peptide (GLP-1) receptor agonists have been shown to not only drastically reduce blood sugars in patients with diabetes, but they also lead to significant weight loss in these patients, which has many downstream benefits,” she told Fox News Digital.
“Together, this reduces the risk of stroke and other complications of diabetes.”
“Like coronary artery disease and heart attacks, strokes are largely preventable if we start early.”
Also recommended are the PCSK9 inhibitors, a class of drugs that Bushnell said are very effective at lowering LDL (bad) cholesterol.
“These medications have also been shown to reduce the risk of stroke,” she added.
Physical activity
For stroke prevention, the ASA has historically recommended 150 minutes of moderate-intensity physical activity, 75 minutes of vigorous-intensity physical activity or a combination of both.
The new set of guidelines emphasizes the importance of not only being physically active, but also avoiding sedentary behavior during waking hours, according to Bushnell.
For stroke prevention, the ASA has historically recommended 150 minutes of moderate-intensity physical activity, 75 minutes of vigorous-intensity physical activity or a combination of both. (iStock)
“We provide a new recommendation for screening for sedentary behavior and counseling patients to avoid being sedentary,” she said.
Tailored guidance for women, other groups
The ASA’s update also includes specific recommendations for certain groups.
For pregnant women, there is guidance for lowering high blood pressure and screening for pregnancy complications, according to Bushnell.
For all women, the ASA also calls for screening for premature ovarian failure (very early menopause before age 40), early-onset menopause (before age 45), and endometriosis (an inflammatory condition caused by endometrial tissue found outside the uterus).
The ASA’s new guidelines include a greater emphasis on screening for women’s health issues. (iStock)
“We also recommend screening for adverse social determinants of health (SDOH), which is new from the prior guidelines,” Bushnell said.
“There is abundant evidence that adverse SDOH can be barriers to prevention — inability to afford health insurance and medications, access to health care, etc. — and therefore increase stroke risk.”
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Overall, Bushnell said, the guidelines offer “relatively simple strategies” that could effectively lower the risk of stroke.
“The main additional point is that all our recommendations will not only lead to better stroke prevention, but also improve brain health,” she said.
The updated guidelines reflect “significant research and clinical lessons” learned over the past 10 years, a cardiologist said. (iStock)
“The risks for dementia are essentially the same as the risks for stroke.”
Overall, Serwer added, the updated guidelines reflect “significant research and clinical lessons” learned over the past 10 years.
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“It is important for professional societies to come together to provide multidisciplinary guidelines to better help our patients,” he said.
“Like coronary artery disease and heart attacks, strokes are largely preventable if we start early.”
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Journalist Katie Couric is sharing a scary medical episode that she experienced on June 27.
In a post on Substack titled “The Day I’ll Never Remember,” she detailed a sudden episode that left her unable to recall the current month, year and president.
“I thought it was 2024. And I believed Joe Biden was president,” she wrote.
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The event occurred while Couric was attending the Aspen Ideas Festival in Colorado, during which she participated in two public panels — one on AI and one on journalism — both of which she cannot remember at all.
“I have no idea what we talked about, or of what occurred when the panels ended,” she said.
Journalist Katie Couric is sharing a scary medical episode that she experienced on June 27. (Getty Images)
John Molner — Couric’s husband, who was in attendance at the festival and the two panels — also shared his account.
After the event, someone told Molner that Katie wasn’t feeling well. When he reached her, an EMT and a doctor were tending to her. “I could tell something was off,” he wrote. “It could have been altitude sickness, but Katie was definitely not all there.”
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At the hospital, when Couric struggled to recall the year, the president and her grandchildren’s names, doctors began checking for a stroke.
An MRI revealed no signs of stroke, which was a relief, but “Katie’s ‘fog’ became a lot more apparent,” Molner wrote.
John Molner, Couric’s husband, who was in attendance at the festival and the two panels, also shared his account. (Getty Images)
“She repeatedly asked me the same questions: ‘What was I doing before we got to the hospital?’ ‘Why am I at the hospital?’”
Couric was ultimately diagnosed with transient global amnesia, a sudden, temporary episode of memory loss that prevents a person from forming new memories and may also erase some recent memories, according to Mayo Clinic.
“The cause seems to be as mysterious as the brain itself.”
It is not caused by a stroke, seizure or head injury, and it usually resolves completely within 24 hours.
“[It’s] just a very weird neural episode that’s pretty uncommon and, at least in most cases, is a ‘one and done’ experience,” Molner said.
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Couric said she finally began feeling “like herself” again around 9 p.m. and went to sleep at 2 a.m.
As TGA leaves a “permanent gap in memory” for the duration of the episode and for hours beforehand, Couric said that from around noon on that day until at least 7 p.m. will remain a “big, black hole.”
As TGA leaves a “permanent gap in memory” for the duration of the episode and for hours beforehand, Couric said that from around noon on that day until at least 7 p.m. will remain a “big, black hole.” (Getty Images)
Data shows that approximately three to eight people per 100,000 will have an episode of transient global amnesia, with people 50 years of age and older at higher risk.
The specific cause of TGA is not known, but some experts believe it stems from a “temporary dysfunction in the brain’s hippocampus — the area responsible for creating new memories,” Couric shared.
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“Doctors believe this is driven by brief interruptions in blood or oxygen flow, or microscopic spasm in the blood vessels.”
Episodes could potentially be triggered by intense physical exertion, emotional distress, extreme temperature changes or migraines, experts say.
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Approximately 15% of patients will have a recurrence 10 years later.
“Why did this happen to me? Was the altitude an issue? Was I dehydrated? Tired? Stressed? The literature doesn’t seem to indicate that these are contributing factors, but the cause seems to be as mysterious as the brain itself,” Couric wrote.
Anyone who experiences sudden memory loss, confusion, difficulty speaking, weakness, numbness, vision changes, severe headache or other stroke-like symptoms should seek immediate medical attention or call 911, doctors advise. (iStock)
“All I know is that those hours will be forever lost. Someone described it as my brain failing to hit the ‘record button.’”
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“While this was a freaky occurrence, it could have been much more serious. So ultimately, I’m relieved — even though several hours of a Saturday in June will always be missing for me.”
Anyone who experiences sudden memory loss, confusion, difficulty speaking, weakness, numbness, vision changes, severe headache or other stroke-like symptoms should seek immediate medical attention or call 911, doctors advise.
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Older adults identified as “super movers” are about half as likely to develop cognitive impairment than their peers.
That’s according to a recent study led by Stony Brook Medicine in New York, which evaluated the cognitive function of 4,000 adults 80 and over who participated in multiple aging and longevity studies over several years.
Among this group, 6% to 10% were classified as super movers, which means they walk at a much faster pace than others of the same age and gender — at speeds comparable to people three decades younger.
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The super movers were found to have about half the risk of cognitive decline compared to seniors with typical gait speed.
The findings were published in the journal Neurology on June 16.
Older adults identified as “super movers” are about half as likely to develop cognitive impairment than their peers. (iStock)
“The study reinforces that mobility and brain health are closely connected,” lead study author Dr. Joe Verghese, MD, neurologist at Stony Brook Medicine, told Fox News Digital. “This suggests that preserving mobility may be an important marker of healthy brain aging and resilience.”
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The most intriguing finding, according to Verghese, was that super movers maintained cognitive function despite having similar dementia-related brain changes as their peers.
In postmortem brain analysis, there was no difference in dementia-related pathologies between the super movers and the slower walkers, the study stated.
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“This suggests they may possess resilience mechanisms that help preserve brain function even in the presence of age-related changes,” he said. “Understanding these resilience factors could lead to new strategies for promoting healthy brain aging.”
As the study was observational, there were some limitations, and it does not prove that walking faster prevents dementia, the researchers noted.
Super movers were found to have about half the risk of cognitive decline compared to seniors with typical gait speed. (iStock)
“Other factors, such as cardiovascular health, physical fitness or genetics, may also contribute to both faster walking and better cognitive outcomes,” Verghese said.
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This study adds to growing evidence that what’s good for the heart and muscles also benefits the brain, he noted, adding that “staying physically active remains one of the most effective, evidence-based ways to support healthy aging.”
“Walking speed is best viewed as a marker of overall health, not a treatment.”
“The broader message is that physical activity is important at any age,” Verghese said. “Walking is an easy step-up point because you don’t need any special equipment. You can do it inside or outdoors, and you can do it on a regular basis. You can walk with a dog, you can walk with a friend.”
Any activity is beneficial if it’s done regularly and with the right intensity, he added.
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Rather than just trying to walk faster, the neurologist recommends that seniors focus on maintaining mobility through regular physical activity, strength training, balance exercises and good cardiovascular health.
“Walking speed is best viewed as a marker of overall health, not a treatment,” Verghese noted.
Major public health guidelines from the CDC and U.S. Physical Activity Guidelines recommend at least 150 minutes of moderate-intensity aerobic activity each week, such as brisk walking.
Major public health guidelines from the CDC and U.S. Physical Activity Guidelines recommend at least 150 minutes of moderate-intensity aerobic activity each week, such as brisk walking. (iStock)
This can be achieved by walking 30 minutes a day, five days a week, or about 20 to 25 minutes most days. Another option is to engage in shorter sessions that add up over the day.
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“You have to do it within your health limitations and medical conditions,” Verghese advised. “So if there are any medical concerns, I would get your physician to clear you before starting exercise.” The good thing about walking, he added, is that you can start at a slow pace and then gradually build up to a brisker pace.
“And then adding on strength and balance training, whatever age you are, I think is also important.”
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