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Primary Stroke Prevention

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Key Points Î Approximately 795,000 people in the United States have a stroke each year, ≈610,000 of whom have had first attacks, resulting in 6.8 million stroke survivors >19 years of age. Î Stroke ranks as the fourth-leading cause of death in the United States. Î Globally, over the past 4 decades, stroke incidence rates have fallen by 42% in high-income countries and increased by 100% in low- and middle-income countries. Stroke incidence rates in low- and middle- income countries now exceed those in high-income countries. Î Stroke is a leading cause of functional impairment. For patients who are ≥65 years of age, 6 months after stroke, 26% are dependent in their activities of daily living, and 46% have cognitive deficits. Î There are enormous opportunities for preventing stroke. An international case-control study of 6000 individuals found that 10 potentially modifiable risk factors explained 90% of the risk of stroke. Î Primary prevention is particularly important because 76% of strokes are first events.

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