Those who make healthy lifestyle choices- such as not smoking, eating a low-fat diet high in fruits and vegetables, drinking in moderation, exercising regularly and maintaining a normal body weight - can lower risk of first time stroke by 80 percent compared to those who don’t make such changes, according to revised American Heart Association/American Stroke Association guidelines.

For the first time, the guidelines address stroke as a broad continuum of related events, including ischemic stroke, non-ischemic stroke and transient ischemic attack (TIA).

For prevention, there is often little difference along the stroke spectrum, said Larry B. Goldstein, chairman of the statement writing committee and director of the Duke Stroke Center in Durham, N.C.

The new guidelines feature several key prevention updates based on recent research:

Emergency room doctors should try to identify patients at high risk for stroke and consider making referrals, conducting screenings or beginning preventive therapy. Although genetic screening for stroke among the general population isn’t recommended, it may be appropriate in certain circumstances, depending on family history and other factors. Doctors must decide whether to perform either procedure on a case-by-case basis.

Aspirin doesn’t prevent a first stroke in low-risk persons or those with diabetes or asymptomatic peripheral artery disease. However, it’s recommended for those whose risk is high enough for the reduction in stroke risk to outweigh the bleeding risks of aspirin.

The guidelines, last updated in 2006, will be published in Stroke: Journal of the American Heart Association.