Template:AHA ASA stroke guidelines 2014
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AHA/ASA Stroke prevention if stroke/TIA (2014, adapted)[1]
- Start BP therapy in previously untreated patients with ischemic stroke or TIA if post-event BP ≥140/≥90 mmHg after several days (Class I; Level of Evidence B).
- Initiation of therapy if BP <140/<90 mmHg is of uncertain benefit (Class IIb; Level of Evidence C).
- Restart BP therapy in those with ischemic stroke or TIA previously treated for HTN (after the first several days) to reduce recurrent stroke and prevention of other vascular events (Class I; Level of Evidence A).
- Target BP level or reduction from pretreatment baseline are unclear and should be individualized; it is reasonable to target <140/<90 mmHg (Class IIa; Level of Evidence B). If recent lacunar stroke, it might be reasonable to target an SBP of <130 mmHg (Class IIb; Level of Evidence B).
- Lifestyle modifications to reduce BP are reasonable part of a comprehensive antihypertensive therapy, including salt restriction, weight loss, high intake of fruit, vegetables, and low-fat dairy products, regular aerobic activity, and limited EtOH consumption (Class IIa; Level of Evidence C).
- The optimal drug regimen to achieve the recommended level of reductions is unclear but diuretics or diuretics+ACE-inhibitors is useful (Class I; Level of Evidence A).
- The choice of specific drugs and targets should be individualized (Class IIa; Level of Evidence B).