[Prevention of cerebral ischemic vascular accidents]

Application of all the measures for primary ischaemic stroke prevention is of major importance because they have a dramatic clinical effect. They are including the modification of lifestyle such as the level of physical activity, alimentation and cigarette smoking. Medications lowering blood pressure, serum cholesterol and glucose levels, and anticoagulants when atrial fibrillation is diagnosed are of proven efficacy. All these measures are also efficient in secondary prevention. Antiplatelets agents in case of atherothrombotic stroke and anticoagulants for cardioembolic stroke are of evident value. Evidence of efficacy of carotid surgery is clearly established for symptomatic tight stenosis. It could be expected that the application to a population of all these measures could result in a more than 50 percent decrease in incidence of ischaemic stroke.