Table 4.

Guideline management recommendations

Factor	Goal	Recommendation
Asymptomatic CAS	No CAS	Endarterectomy may be considered in selected patients with ≥60% stenosis without occlusion, performed by a surgeon with surgical morbidity and mortality <3%; careful patient selection should be guided by individual factors, including comorbid conditions, life expectancy, and patient preference
Cigarette smoking	Cessation	Counseling, nicotine replacement, varenicline, and formal programs are recommended
Diet/nutrition	Well-balanced diet	A diet containing ≥5 servings of fruits and vegetables per day may reduce the risk of stroke
Physical activity	≥30 min of moderate activity/d	Moderate exercise (eg, brisk walking, jogging, cycling, or other aerobic activity)
Alcohol	Moderation	No more than 2 drinks per day for men, and no more than 1 drink per day for women
Drug abuse	Cessation	A history of substance abuse should be part of health evaluation
Sleep apnea	Treatment for OSA	Overnight sleep study in patients with snoring, excessive daytime sleepiness, body mass index over 30, and drug-resistant hypertension; continuous positive airway pressure treatment