The value of screening for metabolic syndrome after stroke is still not clear; however, if it's diagnosed, patients should receive counseling for lifestyle changes (including diet, exercise and weight loss) and treatments for metabolic syndrome components that are also stroke risk factors, especially high blood pressure and high cholesterol.If a stroke survivor has severe blockage of the carotid artery, angioplasty and stenting may be an alternative to surgery if he or she is at low risk for complications. Excluding patients whose stroke or TIA was caused by a clot from the heart, among those taking an antiplatelet drug to prevent another stroke, either aspirin alone, aspirin combined with dipyridamole, or clopidogrel are reasonable options. Therefore, patients and doctors must consider risk factors, cost, tolerance and other characteristics to tailor the appropriate therapy.Stroke or TIA survivors who are diabetic should follow existing guidelines for blood sugar control.All stroke or TIA patients who have carotid artery blockage should aim for optimal medical therapy through a multifaceted approach, including antiplatelet drugs, statin therapy and lifestyle risk factor changes such as blood pressure management.When patients with high stroke risk due to atrial fibrillation (an abnormal heart rhythm) need to temporarily stop taking the anti-clotting drug warfarin, they should receive low molecular weight heparin as bridging therapy to reduce the risk of blood clots.

High blood pressure is the most critical risk factor for recurrent stroke. Doctors should work with patients to find the best drug regimen to suit each individual's blood pressure control needs, said Furie, director of the Massachusetts General Hospital Stroke Service and an associate professor at Harvard Medical School.

SOURCE American Heart Association