Stroke prevention: An uphill battle

Despite considerable advances to reduce the burden of stroke and other cardiovascular diseases, these remain major causes of morbidity and mortality at the population level. Guidelines have delineated contributory causes for both stroke and coronary artery disease and have identified avenues for prevention.1,2 However, in spite of the clear need to improve preventive efforts, many challenges remain for tackling the complexities of stroke prevention.3 Illustrating this concept, in this issue of Neurology®, Boehme et al.4 report disappointing levels of primary and secondary stroke prevention in a large regional cohort of patients with stroke. Even with easy access to and coverage for health care, 80% of people diagnosed with ischemic stroke had at least 1 untreated or inadequately treated medical risk factor (e.g., hypertension, hyperlipidemia, atrial fibrillation). Fully 95% had an inadequately addressed medical risk factor or lifestyle risk factor (smoking, overweight or obesity, excess alcohol use).

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