Abstract Body

Theoretically, up to 90% of all strokes could prevented if all individual risk factors could be set at the theoretical minimum risk exposure level, e.g., zero level of exposure to smoking, alcohol intake, or systolic blood pressure of 110-115 mmHg across the whole population, etc. However, in practice this level of reduction of exposure to risk factors across the world is hardly achievable, at least for the near future. Therefore, in practice realistic goals for primary stroke prevention should be informed by results of reliable randomised controlled trials (RCTs) and modelling, including meta-analysis and systematic reviews. It is also important to consider primary prevention goals that are achievable via population-wide prevention strategies, individual prevention strategies, and both strategies combined. In my presentation, I would like to give an overview of currently available primary stroke prevention strategies, outline evidence from RCTs, difficulties and opportunities for effective primary stroke prevention, realistic medical and economic benefits of stroke prevention, and the most promising ways to improve the situation.

Abstract Body

The 2-3-fold increase in stroke burden across the globe clearly indicates that primary stroke prevention strategies are either not used widely enough or not effective. There are also major between-country gaps in the proportion of recurrent strokes, with some countries (even some developed countries, such as New Zealand) not showing a trend towards improvement at all or very little improvement over the last 30 years. This is suggestive of insufficient implementation of proven effective secondary stroke prevention strategies across the globe, with developing countries suffering the most. This unsatisfactory situation requires analysis of causes of failing primary and secondary stroke prevention strategies and outlining directions and action plans for improving the situation.

In my presentation I will discuss the current trends in stroke burden and risk factors in the world and focus on promising, validated and affordable primary stroke prevention strategies that could be applied across the globe, using strategies outlined in the recent World Stroke Organization Declaration on primary stroke and dementia prevention. These include population-wide and mass individual motivational prevention strategies via widely available and free to use eHealth technologies, such as the Stroke Riskometer app, community interventions by nurses and health volunteers and polypill for people at risk of stroke. I argue that the best way for implementing these strategies is through the support of the WHO and other major international health organisations for these strategies, followed by their inclusion into national and international stroke prevention guidelines endorsed by the national Ministries of Health.