Primary Prevention of Stroke: Identifying High-Risk Patients

The best way to prevent death and disability from stroke is to prevent the first occurrence (i.e., primary prevention). However, many people struggle to adopt healthy behaviors that can reduce the risk of stroke (e.g., physical activity) or abandon unhealthy ones that increase risk (e.g., cigarette smoking). Many patients who are eligible for medications to manage risk factors are not receiving them or not getting the correct agent or dose (e.g., hypertension therapy). Therefore, the great challenge for public health and primary care is to improve the delivery of risk reduction. This chapter describes risk factors for stroke, emphasizing their significant collinearity with risk for coronary artery disease (CAD) and other chronic diseases. We summarize guidelines for managing these risk factors in patient-centered, collaborative, and supportive medical practice.