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Improving Access to Primordial and Primary Stroke Prevention: Global Considerations
Nada El Husseini1, Michelle Nichols2, Mayowa Owolabi3,4,5
1Department of Neurology Duke University Durham NC USA.
Journal of the American Heart Association
|August 12, 2025
Summary
Most strokes are preventable through lifestyle changes and managing risk factors. Equitable access to these primordial and primary prevention strategies is crucial, especially in low- and middle-income countries, to reduce global stroke incidence and disability.
Area of Science:
- Public Health
- Epidemiology
- Preventive Medicine
Background:
- Stroke is a leading global cause of death and disability.
- Incidence is rising in low- and middle-income countries despite advances.
- Prevention strategies are key to mitigating this trend.
Purpose of the Study:
- To review primordial and primary stroke prevention strategies.
- To identify actionable practices for improving access to prevention.
- To highlight the role of policies and population-wide approaches.
Main Methods:
- Topical review of existing literature and strategies.
- Analysis of behavioral and pharmacological prevention methods.
- Examination of social, commercial, and policy determinants of access.
Main Results:
- Most strokes are preventable via primordial (risk factor emergence avoidance) and primary (risk factor management) prevention.
- Strategies include behavioral changes (diet, exercise, smoking cessation) and pharmacological treatments.
- Access is limited by social, environmental, cultural, and policy factors.
Conclusions:
- Equitable access to stroke prevention is essential.
- Novel risk factors (mental stressors, pollution, diet, sex-specific) require attention.
- Mobilizing multi-level efforts is necessary for effective stroke prevention implementation.
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