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Primary prevention of stroke

Jorge Moncayo-Gaete MD (Dr. Moncayo-Gaete of the International University of Ecuador has no relevant financial relationships to disclose.)
Julien Bogousslavsky MD (Dr. Bogousslavsky of the Swiss Medical Network has no relevant financial relationships to disclose.)
Steven R Levine MD, editor. (Dr. Levine of the SUNY Health Science Center at Brooklyn has received honorariums from Genentech for service on a scientific advisory committee and a research grant from Genentech as a principal investigator.)
Originally released June 6, 2012; last updated March 5, 2018; expires March 5, 2021

Introduction

This article includes discussion of primary prevention of stroke, alcohol and stroke, asymptomatic carotid artery disease and stroke, atrial fibrillation and stroke, cigarette smoking and stroke, diabetes mellitus and stroke, dietary factors, obesity, and stroke, hyperhomocysteinemia and stroke, estrogens and stroke, hypertension and stroke, lipid abnormalities and stroke, migraine and stroke, physical activity and stroke, and sickle cell disease and stroke. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.

Overview

Prevention of stroke and transient ischemic attack includes both conventional approaches to vascular risk factor management (blood pressure lowering, cholesterol reduction with statins, smoking cessation, and antiplatelet therapy) and more specific interventions, such as carotid revascularization or anticoagulation for atrial fibrillation. In this article, the authors discuss effective interventions for optimal primary stroke prevention.

Key points

• Key risk factors for stroke include the following:
 

- alcohol
- asymptomatic carotid artery disease
- atrial fibrillation
- cigarette smoking
- diabetes mellitus
- dietary factors and obesity
- estrogens
- hyperhomocysteinemia
- hypertension
- lipid abnormalities
- migraine
- physical activity (lack of)
- sickle cell disease

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