Stroke - secondary prevention

Stroke prevalence, mortality and disability rates are connected with stroke recurrence. Recurrent stroke occurs in 10-12% of patients during first 12 month after stroke onset and in 5-8% of patient each next year. The risk of death and higher degree of disability is higher among the patients with recurrent stroke that in patient with first ever stroke. Prophylactic treatment is the most important management in stroke patients. Risk factors may directly influence incidence or indirectly the natural course of disease. Among reversible risk factors the most important are: hypertension, heart disease, diabetes, smoking, diet and low physical activity. In the last years the results of experimental and clinical studies indicate that high level of homocysteine may be the new modificable risk of vasogenic brain injury. Modification of stroke risk factors together with antiplatelet or anticoagulant therapy had major influence on decrease of stroke mortality in Western Europe and USA, where not only stroke incidence dropped down, but also strokes become less severe. In Poland prevalence of stroke risk factors is high and proper preventive treatment is definitively not enough prescribed. The article presents the principles of secondary prevention stroke in ischaemic stroke.