[From acute care to long-term management: reflections on models for stroke recurrence prevention]

Stroke is the leading cause of death and disability in China. In recent years, acute stroke care in China has improved substantially with the continued development of stroke centers and rapid advances in emergency reperfusion therapy technology. Nevertheless, the risk of stroke recurrence remains high, and long-term management has become a critical determinant of long-term prognosis of patients. Currently, a large amount of evidence has established the efficacy of secondary prevention strategies, including antithrombotic therapy, risk factor control, and lifestyle modification. The main challenge in preventing stroke recurrence is not the lack of effective interventions, but the lack of an effective delivery system to translate evidence-based interventions and guideline recommendations into sustained, standardized practice throughout the course of care. Drawing on experience in stroke prevention and chronic disease management at home and abroad, this article analyzes the problems of inadequate long-term risk factor control, declining medication adherence, and discontinuity of care. We propose that stroke recurrence prevention should further shift from a model centered primarily on acute-phase treatment to a systematic management that spans in-hospital and out-of-hospital settings and covers the entire disease course. We propose a model oriented toward reducing disability and disease burden, grounded in standardized assessment, aimed at comprehensive control, delivered through continuous management, and supported by multistakeholder collaboration. This article may provide reference for further improving China's stroke prevention and control system and advancing full-cycle health management of stroke.