Fast Five Quiz: Stroke Prevention in Atrial Fibrillation

Brian Silver, MD

Disclosures

September 10, 2019

Hypertension is regarded as the most important modifiable risk factor for stroke and intracerebral hemorrhage, and the risk for stroke increases progressively with increasing blood pressure, independent of other factors. Other modifiable risk factors include cigarette smoking, diabetes, dyslipidemia, sickle cell disease, postmenopausal hormone replacement therapy, depression, diet, activity, body weight, and body fat. Modifiable risk factors should be managed in accordance with best practices, and smoking cessation, blood pressure control, diabetes control, a low-fat diet (eg, Dietary Approaches to Stop Hypertension [DASH] or Mediterranean diet), weight loss, and regular exercise should be encouraged for all patients as appropriate.

The link between AFib and risk for stroke is now beyond dispute, with studies indicating that diagnosed AFib increases the risk for stroke four to five times. Similarly, 1 in 5 patients diagnosed with stroke is also found to have AFib. Diagnosing AFib before the first complications occur is a recognized priority for the prevention of strokes. AFib can be successfully controlled by the detection and management of risk factors, by rhythm control treatments, and by the use of antithrombotic therapies. These therapies have been improved in the past few years by the introduction of new anticoagulant drugs, such that AFib, like cigarette smoking and hypertension, may now be considered a modifiable risk factor for stroke, whose treatment can reduce the degree of risk.

For more recommendations for stroke prevention, go here

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