Cerebral stroke is one of the leading causes of death and a major cause of disability world wide. During the recent decade acute treatment of ischemic stroke has improved significantly. The emphasis on urgent assessment and need for early rehabilitation has been recognised. Even so the best treatment for stroke is the preventive approach, especially seen from a global perspective. In this review the most important risk factors of stroke, especially of ischemic etiology, are presented and preventive measures are discussed.
Risk factors for stroke can be categorised in non-modifiable and modifiable factors. Age is the most important non-modifiable risk factor since the prevalence of cerebral stroke increases significantly with age. Of the modifiable risk factors is hypertension the most essential one, atrial fibrillation being another important factor. Adequate screening and treatment for these are vital preventive measures. Active treatment of elevated blood pressure levels is one of the most cost-effective preventive measures. For mild to moderate hypertension life-style intervention, with a regimen of low salt-intake, increased amount of physical activity, smoking cessation, weight reduction and only moderate alcohol consumption, can be enough to reduce high blood pressure. For individuals with diabetes or hyperlipidemia a more aggressive approach is recommended with antihypertensive and lipid-lowering medication.
Individual aspects in the patients profile such as atherosclerotic disease, hypercholesterole-mia, heart disease, diabetes, cigarette smoking and use of alcohol can guide the need for further medical therapy and other interventions available in both primary and secondary prevention.