GPs are ideally placed to identify patients with modifiable risk factors for stroke and to institute prevention strategies, including lifestyle changes and antihypertensive and anticoagulation therapy when appropriate. GPs can also help reduce morbidity in stroke survivors through recognising and managing complications such as depression, sexual dysfunction and fatigue.
- Stroke is a leading cause of death and disability in Australia.
- All patients with suspected stroke and ongoing symptoms should be sent immediately to a hospital emergency department, and all with transient neurological deficits should be urgently referred to a transient ischaemic attack clinic.
- Stroke can be categorised by noncontrast CT as ischaemic or haemorrhagic; ischaemic stroke is more common and may be due to small-vessel disease, cardioembolism or extracranial atherosclerosis.
- Antihypertensive therapy, statins and, if atrial fibrillation is not detected, antiplatelet therapy form the mainstays of secondary prevention; if atrial fibrillation is detected, anticoagulation is required.
- Lifestyle modification is a key component of stroke prevention: all patients should be encouraged to increase consumption of fruit and vegetables and reduce salt intake; those who are sedentary should be encouraged to increase physical activity.
- GPs are ideally placed to identify common complications in stroke survivors, such as depression, fatigue and sexual dysfunction, and to initiate treatment or refer as appropriate.