Cambios de estilo de

vida.
Guía de la AHA/ASA de 2021 para la
prevención del accidente
cerebrovascular en pacientes con
accidente cerebrovascular y ataque
isquémico transitorio
Nutricion

2
Vascular Risk Factor Management: Nutrition
Stroke or transient ischemic attack + hypertension
(if not currently restricting dietary sodium)
Mediterranean type diet (in preference to low-fat diet)
(Class 2a)
In patients with stroke or TIA and
Mediterranean Diet (Summarized) hypertension who are not currently
• High monounsaturated/saturated fat ratio
restricting their dietary
(use of olive oil as main cooking ingredient and/or consumption sodium intake, it is reasonable to
of other traditional foods high in monounsaturated fats such as recommend that individuals reduce
tree nuts)
their sodium intake by
• High intake of plant‐based foods, including fruits, at least 1g/d sodium (2.5 grams/day
vegetables and legumes
salt) to reduce the risk of
• High consumption of whole grains and cereals cardiovascular disease (CVD)
• Increased consumption of fish events (including stroke)
• Low consumption of meat and meat products (Class 2a)
• Discourages red and processed meats
• Low to moderate red wine consumption
• Moderate consumption of milk and dairy products
Reduced risk of
• Discourages soda drinks, pastries, sweets, commercial cardiovascular
bakery products and spread fats
disease events
(including stroke)
Reduced risk of recurrent stroke

Kleindorfer, D. O., et al. (2021). 2021 AHA/ASA Guideline for the Prevention of Stroke in Patients With Stroke and Transient 3
Ischemic Attack. Stroke.
Vascular Risk Factor Management: Physical Activity
PATIENT
COR RECOMMENDATIONS IMPACT
POPULATION
Moderate intensity aerobic activity for a
Lower risk of recurrent stroke and
minimum of 10 minutes 4 times a week
Capable of composite cardiovascular endpoint of
1 physical activity
OR
recurrent stroke, myocardial infarction,
Vigorous intensity aerobic activity for a
or vascular death
minimum of 20 minutes 2 times a week
Engage in exercise class that includes Reduces cardiometabolic risk factors
Able to increase
2a physical activity
counseling to change physical activity and increases leisure time physical
behavior activity participation
Supervision of exercise program by health
Impaired ability to care professional (ex. physical therapist, Beneficial for secondary stroke
2a exercise cardiac rehabilitation professional) in prevention
addition to routine rehabilitation

Sit for long Break up sedentary time with intervals as

2b periods of short as 3 minutes of standing OR light Improves cardiovascular health
uninterrupted time exercise every 30 minutes

Kleindorfer, D. O., et al. (2021). 2021 AHA/ASA Guideline for the Prevention of Stroke in Patients With Stroke and Transient 4
Ischemic Attack. Stroke.
Vascular Risk Factor Management:
Smoking Cessation and Substance Use
Tobacco Alcohol
Environmental If consumption: Counsel eliminate or reduce
Current smoker Men: >2 alcoholic drinks per day consumption of alcohol to reduce
(passive)
exposure Women: >1 alcoholic drink per day stroke risk (Class 1)

Counsel stop Stimulant use

smoking ± drug
therapy* Avoid exposure Stimulant use† or
(or reduce use if (Class 1) Counsel behavior is health risk
patients with infective endocarditis
unable to) and to stop use (Class 1)
(with intravenous drug use)
(Class 1)
†
i.e., amphetamines, amphetamine derivatives, cocaine, or
khat
Reduces risk of recurrent stroke
Substance use
*Nicotine replacement, bupropion,
varenicline
Substance use disorders Specialized services to help
(drugs and/or alcohol) manage dependency (Class 1)

Kleindorfer, D. O., et al. (2021). 2021 AHA/ASA Guideline for the Prevention of Stroke in Patients With Stroke and Transient 5
Ischemic Attack. Stroke.