[Stroke--primary prophylaxis]

Abstract

Background: The estimated annual incidence of stroke in Norway is 15,000; 5,000 have a lethal outcome. 11,500 patients are affected for the first time. The incidence of stroke is expected to rise considerably in the future, due to an increasing number of elderly. The aim of this review article is to present updated treatment recommendations for primary prophylaxis of stroke.

Material and methods: This article is based on guidelines from The European Stroke Initiative and the American Stroke Association Guidelines and on literature found in Medline and the Cochrane Library. The results from new randomised clinical studies are also included. Therapeutic guidelines have been modified for Norwegian use.

Results and interpretation: Active treatment of modifiable risk factors such as hypertension, dyslipidaemia and atrial fibrillation can reduce the number of patients who develop a stroke. There is considerable evidence suggesting that a substantial proportion of the population with high blood pressure receive insufficient treatment. More active treatment of this condition is probably the most efficient single measure. Lifestyle factors such as smoking, diet, physical inactivity and obesity contribute to the relatively high incidence of stroke in Norway.