Secondary prevention of stroke

Prevention of further strokes in stroke survivors involves a detailed assessment and management plan for each stroke survivor's vascular risk factors. It should be emphasized that managing risk factors for stroke has added the benefit of helping to manage other vascular diseases, including coronary artery disease and peripheral vascular disease. Vascular risk factor modification for the prevention of recurrent stroke can be divided into two categories: non-modifiable vascular risk factors and modifiable vascular risk factors. This chapter presents a general statement and a brief evidence summary for following modifiable vascular risk factors: hypertension, dyslipidemia, diabetes management, smoking cessation, antithrombotic agents in stroke survivors with and without atrial fibrillation, endarterectomy for symptomatic carotid disease, obstructive sleep apnea management and lifestyle management. Factors that fall under lifestyle management include: eating a balanced diet, limiting salt intake, moderating alcohol consumption, increasing physical activity, and optimizing weight.