Stroke prevention encompasses risk factor reduction, both at a population and individual level. Implementing optimal stroke prevention strategies throughout the whole continuum of care has the potential to reduce the incidence of stroke by as much as 80%. (Rothwell, P.M. et al. (2007)

Primary prevention of stroke includes lifestyle modifications and measures to control blood pressure, cholesterol levels, diabetes mellitus, and atrial fibrillation. Lowering blood pressure in patients with hypertension prevents both hemorrhagic and ischemic stroke (relative risk reduction, 35 to 45 percent).

Secondary Prevention:

Secondary Prevention of stroke is an individually based, clinical approach to reducing the risk of events in persons who are experiencing symptoms that place them at high risk of a stroke or have already experienced a transient ischemic attack (TIA) or mild non-disabling stroke. Prevention strategies may include medication, surgery and support in making changes to lifestyle.

Stroke Prevention Clinics

• TOH Stroke Prevention Clinic
• Hawkesbury Prevention Clinic

Stroke Prevention Resources

• Stroke Risk Factors
•  TOH TIA Booklet
•  TOH TIA Alogrithm
• HSFO TIA booklet 

References:

Johnston, S.C., Gress, D.R., Browner, W.S. and Sidney, S. (2000).Short term prognosis after emergency department diagnosis of TIA.  JAMA, 284 (22), 2901-2906.

Gladstone, DJ, et al. Mar 30, 2004. Management and outcomes of transient ischemic attacks in Ontario.  CMAJ 170(7): 1099-1104. 

Johnston, S.C. et al. (2007) Validataion and refinement of scores to predict very early stroke risk after transient ischemic attack. The Lancet, 369, (9558), 27 January 2007-2 February 2007, 283-92.

Rothwell, P.M. et al. (2007).  Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study) : a prospective population based sequential comparison.  The Lancet, 370 (9596), 20 October 2007-26 October 2007, 1432-1442.

NEW Ontario Stroke System Secondary Prevention web initiative

Please visit the Ontario Stroke System Secondary Prevention web initiative on the HSFO Prof Ed web site. This web initiative, developed by clinicians from across the province, is intended to provide access to information, resources, tools and support for primary care practitioners in managing TIA’s and early symptoms of stroke. The link is http://www.heartandstroke.ca/profedGo to STROKE and then STROKE CARE RESOURCES/PREVENTION. The secondary stroke prevention web section includes the following sections and links:

• TIA stats and facts
• What's new
• OSS Secondary Stroke Prevention Model
• Medical Management and links to evidence and best practice guidelines/recommendations
• Secondary Stroke Prevention Clinics: clinic locator, description of the clinics, access and contact information
• Resources: educational opportunities related to stroke, relevant links, sites and resource material A bookmark has been developed to alert individuals to the site.

A HSFO bookmark can be ordered through: 416-489-7111, 389 or This e-mail address is being protected from spam bots, you need JavaScript enabled to view it Inventory ( attached) #: PE-BOOKMARK101-F08