Treatment
2
Table 3. Physical Inactivity
Recommendations
COR LOE
Physical activity is recommended because it is associated with a
reduction in the risk of stroke.
I B
Healthy adults should perform at least moderate to vigorous-intensity
aerobic physical activity at least 40 min/3-4d/wk.
I B
Table 4. Dyslipidemia
Recommendations
COR LOE
In addition to therapeutic lifestyle changes, treatment with an HMG
coenzyme-A reductase inhibitor (statin) medication is recommended
for the primary prevention of ischemic stroke in patients estimated
to have a high 10-year risk for cardiovascular events as recommended
in the 2013 ACC/AHA Guideline on the Treatment of Blood
Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults.
I A
Niacin may be considered for patients with low HDL cholesterol
or elevated Lp(a), but its efficacy in preventing ischemic stroke in
patients with these conditions is not established. Caution should be
used with niacin because it increases the risk of myopathy.
IIb B
Fibric acid derivatives may be considered for patients with
hypertriglyceridemia, but their efficacy in preventing ischemic stroke
is not established.
IIb C
Treatment with nonstatin lipid-lowering therapies such as fibric
acid derivatives, bile acid sequestrants, niacin, and ezetimibe may be
considered in patients who cannot tolerate statins, but their efficacy
in preventing stroke is not established.
IIb C
Table 5. Diet and Nutrition
Recommendations
COR LOE
Reduced intake of sodium and increased intake of potassium
as indicated in the US Dietary Guidelines for Americans are
recommended to lower BP.
I A
A DASH-style diet, which emphasizes fruits, vegetables, and low-fat
dairy products and reduced saturated fat, is recommended to lower
BP.
I A
A diet that is rich in fruits and vegetables and thereby high in
potassium is beneficial and may lower the risk of stroke.
I B
A Mediterranean diet supplemented with nuts may be considered in
lowering the risk of stroke.
IIa B
