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Feature Article

Managing risk factors to prevent stroke

David W Dunbabin

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Abstract

Important risk factors for stroke include elevated blood pressure, smoking, hypercholesterolaemia, diabetes, atrial fibrillation and lifestyle factors. Modifying these risk factors represents the most potent and cost-effective way of reducing the burden of stroke.

Key Points

  • GPs have a critical role in stroke prevention by identifying patients with risk factors for stroke.
  • Elevated blood pressure and cholesterol levels, smoking, atrial fibrillation, poor diet, overweight and sedentary lifestyle are modifiable risk factors for stroke.
  • Patients at high risk of stroke, such as those presenting with transient ischaemic attack (TIA) or minor stroke, warrant urgent investigation and management. Therapy may include antiplatelet drugs, anticoagulants, carotid endarterectomy and aggressive risk factor management, aiming for target blood pressure levels of approximately 140/90 mmHg or lower, and total cholesterol levels of less than 4 mmol/L.
  • Patient adherence to preventive treatments such as antihypertensives, anticoagulation and lipid-lowering agents remains poor, with education and reinforcement needed.

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