Razavi Alexander C, Troy Aaron L, Patel Jaideep, Mehta Laxmi S, Spitz Jared A, Lloyd-Jones Donald, Whelton Seamus P, Johansen Michelle C, Blumenthal Roger S
Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA.
Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
JACC Adv. 2025 Jun;4(6 Pt 2):101724. doi: 10.1016/j.jacadv.2025.101724. Epub 2025 May 8.
Approximately 9 to 10 million adults (4%) have experienced a stroke in the United States. While stroke incidence has generally declined, progress has been less pronounced among young individuals, and such trends have underlined the importance of focusing on the primary prevention of stroke. In 2024, the American Heart Association and American Stroke Association released new guidelines for the primary prevention of stroke. Here, we review major updates in 7 domains: dietary modification, glucagon-like peptide-1 receptor agonists, blood pressure targets, lipid-lowering medications, antithrombotic agents, colchicine therapy, and sex-specific preventive risk assessment. Through this process, we review important randomized controlled trial evidence contributing to guideline updates and provide key perspectives on the incorporation of lifestyle and pharmacotherapy for personalized stroke prevention.
在美国，约900万至1000万成年人（占4%）曾经历过中风。虽然中风发病率总体呈下降趋势，但在年轻人中进展不太明显，这些趋势凸显了关注中风一级预防的重要性。2024年，美国心脏协会和美国中风协会发布了中风一级预防的新指南。在此，我们回顾7个领域的主要更新内容：饮食调整、胰高血糖素样肽-1受体激动剂、血压目标、降脂药物、抗血栓药物、秋水仙碱治疗以及性别特异性预防风险评估。通过这一过程，我们回顾了有助于指南更新的重要随机对照试验证据，并就将生活方式和药物治疗纳入个性化中风预防提供关键观点。
