Tuesday, November 28, 2023

Stroke Prevention

Practice Essentials

Primary stroke prevention refers to the treatment of individuals with no history of stroke. Secondary stroke prevention refers to the treatment of individuals who have already had a stroke or transient ischemic attack.

Primary Prevention of Stroke

Risk-reduction measures in primary stroke prevention may include the use of antihypertensive medications, anticoagulants, platelet antiaggregants, 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins), smoking cessation, dietary intervention, weight loss, and exercise.

Modifiable risk factors include the following:


Air pollution

Cigarette smoking



Atrial fibrillation

Sickle cell disease

Postmenopausal HRT


Diet and activity

Weight and body fat

Secondary Prevention of Stroke

Secondary prevention can be summarized by the mnemonic A, B, C, D, E, as follows:

A – Antiaggregants (aspirin, clopidogrel, extended-release dipyridamole, ticlopidine) and anticoagulants (apixaban, dabigatran, edoxaban, rivaroxaban, warfarin)

B – Blood pressure–lowering medications

C – Cessation of cigarette smoking, cholesterol-lowering medications, carotid revascularization

D – Diet

E – Exercise

Smoking cessation, blood pressure control, diabetes control, a low-fat diet (eg, Dietary Approaches to Stop Hypertension [DASH] or Mediterranean diets), weight loss, and regular exercise should be encouraged.

- Advertisment -

Most Popular