The 2017 update of the Canadian Stroke Best Practice Recommendations (CSBPR) for the Secondary Prevention of Stroke

 

The Heart & Stroke Canadian Stroke Best Practice Recommendations (CSBPR) for the Secondary Prevention of Stroke provide guidance for the prevention of ischemic stroke recurrence through the identification and management of modifiable vascular risk factors, including guidelines regarding the management of patent foramen ovale based on the most current published evidence. A webinar on this topic is available here and included in the list of archived webinars.

A new component of the CSBPR released with this edition includes a model of the core elements for delivering secondary stroke prevention services. This enables service providers to evaluate and improve the services they provide to ensure patients have the best outcomes possible. Other notable additions are a section on cervical artery dissection (a webinar on the topic is available on the CSBPR website.) Recommendations on management of sleep apnea have been removed in this update.

Recommendations include those related to diagnostic testing, diet and lifestyle, smoking, hypertension, hyperlipidemia, diabetes, antiplatelet and anticoagulant therapies, carotid artery disease, atrial fibrillation and other cardiac conditions. While the focus of these recommendations is on recurrent stroke risk reduction in patients who have experienced a stroke or transient ischemic attack, there is also some guidance for healthcare providers for individuals at risk of a first stroke. However, only selected recommendations related to primary prevention are included.

The guidelines further emphasize the need for a systems approach to stroke care, involving an interprofessional team, with access to specialists and diagnostic testing regardless of patient location, and the need to overcome geographic barriers to ensure equity in access within a universal health-care system.

The Heart & Stroke Canadian Stroke Best Practice Consensus Statement: Secondary Stroke Prevention during Pregnancy was also recently released. This consensus statement provides the first broad-based, stroke-specific guidance around stroke in pregnancy in the world.

The revised Secondary Prevention of Stroke recommendations are published in the International Journal of Stroke and are part of the sixth edition of the Heart & Stroke Canadian Stroke Best Practice Recommendations. The writing group chairs were Theodore Wein and David Gladstone.

Supporting materials such as implementation resources to facilitate the adoption of evidence to practice, and related performance measures to enable monitoring of uptake and effectiveness of the recommendations are available at www.strokebestpractices.ca.

Click here to download the recommendations from the International Journal of Stroke website.

Click here to access the methodology on the CSPBR website.

Click here to download the newly released Consensus Statement: Secondary Stroke Prevention during Pregnancy statement from the International Journal of Stroke website.

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