Clinical recommendation	Evidence rating	References
After an ischemic stroke, all patients should have a swallowing assessment before oral nutrition or oral medications are initiated.	C	1
Prophylactic unfractionated or low-molecular-weight heparin should be started in patients with restricted mobility after ischemic stroke, unless there is a contraindication to the therapy, to reduce the risk of venous thromboembolism.	B	1, 15, 16
All patients with ischemic stroke who have not received thrombolytics and who do not have contraindications to aspirin should be started on aspirin within 24 to 48 hours of symptom onset.	B	20
Aspirin monotherapy, aspirin/dipyridamole (Aggrenox), and clopidogrel monotherapy (Plavix) are acceptable options to reduce the risk of recurrent stroke.	C	25
Therapeutic heparin should not be used for subacute ischemic stroke, including cardioembolic stroke.*	B	25, 26
Statin therapy should be initiated in all patients following ischemic stroke if the low-density lipoprotein cholesterol level is greater than 100 mg per dL (2.59 mmol per L), with a goal level of 70 mg per dL (1.81 mmol per L) or a reduction of 50 percent.	B	25, 27
Arterial hypertension should not be treated in the first 24 hours after ischemic stroke, unless blood pressure exceeds 220/120 mm Hg†	C	1