Secondary Prevention of Stroke: The role of the General Practitioner

The increased risk of ischaemic events following a stroke, and the associated morbidity and  mortality, makes secondary prevention an important therapeutic goal. Nevertheless, for  reasons relating to both physicians and patients, a well documented gap remains between  evidence and clinical practice in many aspects of cardiovascular disease.

Reducing the burden of recurrent stroke clearly relies not only on an increasing understanding  of the aetiologial factors that influence the development of stroke, but also on the services of  primary care physicians such as lifestyle modifications, pharmacological treatment and referral  for consideration of surgery.

Assessment of secondary prevention and the discrepancy between evidence and practice is difficult due to the variations between clinical studies, for example in different target  populations, length of follow up, drop out rates and outcomes. It is similarly challenging to relate the results of these clinical trials to individual patients, each with numerous risk factors of  varying significance.