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Review
. 2022 Jan;7(1):e74-e85.
doi: 10.1016/S2468-2667(21)00230-9. Epub 2021 Oct 29.

Primary stroke prevention worldwide: translating evidence into action

Mayowa O Owolabi  1 , Amanda G Thrift  2 , Ajay Mahal  3 , Marie Ishida  3 , Sheila Martins  4 , Walter D Johnson  5 , Jeyaraj Pandian  6 , Foad Abd-Allah  7 , Joseph Yaria  8 , Hoang T Phan  9 , Greg Roth  10 , Seana L Gall  11 , Richard Beare  12 , Thanh G Phan  9 , Robert Mikulik  13 , Rufus O Akinyemi  14 , Bo Norrving  15 , Michael Brainin  16 , Valery L Feigin  17 ; Stroke Experts Collaboration Group
Collaborators, Affiliations
Review

Primary stroke prevention worldwide: translating evidence into action

Mayowa O Owolabi et al. Lancet Public Health. 2022 Jan.

Erratum in

Abstract

Stroke is the second leading cause of death and the third leading cause of disability worldwide and its burden is increasing rapidly in low-income and middle-income countries, many of which are unable to face the challenges it imposes. In this Health Policy paper on primary stroke prevention, we provide an overview of the current situation regarding primary prevention services, estimate the cost of stroke and stroke prevention, and identify deficiencies in existing guidelines and gaps in primary prevention. We also offer a set of pragmatic solutions for implementation of primary stroke prevention, with an emphasis on the role of governments and population-wide strategies, including task-shifting and sharing and health system re-engineering. Implementation of primary stroke prevention involves patients, health professionals, funders, policy makers, implementation partners, and the entire population along the life course.

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Conflict of interest statement

Declaration of interests VLF declares that the PreventS web app and Stroke Riskometer app are owned and copyrighted by Auckland University of Technology; has received grants from the Brain Research New Zealand Centre of Research Excellence (16/STH/36), Australian National Health and Medical Research Council (NHMRC; APP1182071), and World Stroke Organization (WSO); is an executive committee member of WSO, honorary medical director of Stroke Central New Zealand, and CEO of New Zealand Stroke Education charitable Trust. AGT declares funding from NHMRC (GNT1042600, GNT1122455, GNT1171966, GNT1143155, and GNT1182017), Stroke Foundation Australia (SG1807), and Heart Foundation Australia (VG102282); and board membership of the Stroke Foundation (Australia). SLG is funded by the National Health Foundation of Australia (Future Leader Fellowship 102061) and NHMRC (GNT1182071, GNT1143155, and GNT1128373). RM is supported by the Implementation Research Network in Stroke Care Quality of the European Cooperation in Science and Technology (project CA18118) and by the IRIS-TEPUS project from the inter-excellence inter-cost programme of the Ministry of Education, Youth and Sports of the Czech Republic (project LTC20051). BN declares receiving fees for data management committee work for SOCRATES and THALES trials for AstraZeneca and fees for data management committee work for NAVIGATE-ESUS trial from Bayer. All other authors declare no competing interests.

Figures

Figure 1
Figure 1
Optimal shift in the distribution of cardiovascular disease risks through a combination of population-wide strategies for high-risk cardiovascular disease prevention Areas shadowed in green show a theoretically possible proportion of the population that could benefit from (A) a population-wide prevention strategy, (B) strategies for high-risk cardiovascular disease prevention, and (C) a motivational mass individual risk prevention strategy regardless of the cardiovascular disease risk (ie, use of mobile applications to reduce lifestyle and other risk factors). Modified from Feigin and colleagues, with permission.
Figure 2
Figure 2
Action plan for governments and other policy makers for primary stroke prevention measures at the population (ie, socioeconomic, environmental, and behavioural) and individual levels
See this image and copyright information in PMC

References

    1. Feigin VL, Stark BA, Johnson CO, et al. Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol. 2021;20:795–820. - PMC - PubMed
    1. UN General Assembly Resolution adopted by the General Assembly: 66/2: political declaration of the high-level meeting of the General Assembly on the Prevention and Control of Non-Communicable Diseases. Sept 16, 2011. https://www.un.org/en/ga/ncdmeeting2011/
    1. WHO . World Health Organization; Geneva: 2013. Global Action Plan for the prevention and control of noncommunicable diseases 2013–2020.
    1. UN General Assembly Seventy-second session. Progress on the prevention and control of non-communicable diseases. Report of the Secretary-General. Dec 21, 2017. https://ncdalliance.org/sites/default/files/resource_files/UNSG%20Report...
    1. Sliwa K, Yacoub M. Catalysing the response to NCDI Poverty at a time of COVID-19. Lancet. 2020;396:941–943. - PMC - PubMed

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