scholarly journals Perioperative Neurological Evaluation and Management to Lower the Risk of Acute Stroke in Patients Undergoing Noncardiac, Nonneurological Surgery: A Scientific Statement From the American Heart Association/American Stroke Association

Circulation ◽  
2021 ◽  
Author(s):  
Curtis Benesch ◽  
Laurent G. Glance ◽  
Colin P. Derdeyn ◽  
Lee A. Fleisher ◽  
Robert G. Holloway ◽  
...  
Keyword(s):  
Intravenous Thrombolysis ◽  
Heart Association ◽  
Pressure Control ◽  
Neurological Dysfunction ◽  
Anesthetic Technique ◽  
Perioperative Stroke ◽  
Carotid Revascularization ◽  
Preoperative Optimization ◽  
Scientific Statement

Perioperative stroke is a potentially devastating complication in patients undergoing noncardiac, nonneurological surgery. This scientific statement summarizes established risk factors for perioperative stroke, preoperative and intraoperative strategies to mitigate the risk of stroke, suggestions for postoperative assessments, and treatment approaches for minimizing permanent neurological dysfunction in patients who experience a perioperative stroke. The first section focuses on preoperative optimization, including the role of preoperative carotid revascularization in patients with high-grade carotid stenosis and delaying surgery in patients with recent strokes. The second section reviews intraoperative strategies to reduce the risk of stroke, focusing on blood pressure control, perioperative goal-directed therapy, blood transfusion, and anesthetic technique. Finally, this statement presents strategies for the evaluation and treatment of patients with suspected postoperative strokes and, in particular, highlights the value of rapid recognition of strokes and the early use of intravenous thrombolysis and mechanical embolectomy in appropriate patients.

scholarly journals Medication Adherence and Blood Pressure Control: A Scientific Statement From the American Heart Association

Hypertension ◽  
2021 ◽  
Author(s):  
Niteesh K. Choudhry ◽  
Ian M. Kronish ◽  
Wanpen Vongpatanasin ◽  
Keith C. Ferdinand ◽  
Valory N. Pavlik ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Blood Pressure Control ◽  
Heart Association ◽  
Pressure Control ◽  
Medication Nonadherence ◽  
Antihypertensive Medications ◽  
Poor Blood Pressure Control ◽  
Scientific Statement ◽  
The Individual

The widespread treatment of hypertension and resultant improvement in blood pressure have been major contributors to the dramatic age-specific decline in heart disease and stroke. Despite this progress, a persistent gap remains between stated public health targets and achieved blood pressure control rates. Many factors may be important contributors to the gap between population hypertension control goals and currently observed control levels. Among them is the extent to which patients adhere to prescribed treatment. The goal of this scientific statement is to summarize the current state of knowledge of the contribution of medication nonadherence to the national prevalence of poor blood pressure control, methods for measuring medication adherence and their associated challenges, risk factors for antihypertensive medication nonadherence, and strategies for improving adherence to antihypertensive medications at both the individual and health system levels.

scholarly journals Considerations for Reduction of Risk of Perioperative Stroke in Adult Patients Undergoing Cardiac and Thoracic Aortic Operations: A Scientific Statement From the American Heart Association

Circulation ◽  
2020 ◽  
Vol 142 (14) ◽  
Author(s):  
Mario Gaudino ◽  
Curtis Benesch ◽  
Faisal Bakaeen ◽  
Abe DeAnda ◽  
Stephen E. Fremes ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
Diagnosis And Treatment ◽  
Perioperative Stroke ◽  
Neurological Risk ◽  
Prediction And Prevention ◽  
Scientific Statement ◽  
Timing Of Onset

Perioperative stroke is one of the most severe and feared complications of cardiac surgery. Based on the timing of onset and detection, perioperative stroke can be classified as intraoperative or postoperative. The pathogenesis of perioperative stroke is multifactorial, which makes prediction and prevention challenging. However, information on its incidence, mechanisms, diagnosis, and treatment can be helpful in minimizing the perioperative neurological risk for individual patients. We herein provide suggestions on preoperative, intraoperative, and postoperative strategies aimed at reducing the risk of perioperative stroke and at improving the outcomes of patients who experience a perioperative stroke.

scholarly journals Role of Biomarkers for the Prevention, Assessment, and Management of Heart Failure: A Scientific Statement From the American Heart Association

Circulation ◽  
2017 ◽  
Vol 135 (22) ◽  
Author(s):  
Sheryl L. Chow ◽  
Alan S. Maisel ◽  
Inder Anand ◽  
Biykem Bozkurt ◽  
Rudolf A. de Boer ◽  
...  
Keyword(s):  
Heart Failure ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
Scientific Statement
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