4.7 Article

Primary stroke prevention worldwide: translating evidence into action

Journal

LANCET PUBLIC HEALTH
Volume 7, Issue 1, Pages E74-E85

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/S2468-2667(21)00230-9

Keywords

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Funding

  1. World Stroke Organization
  2. Auckland University of Technology
  3. Health Research Council of New Zealand
  4. US National Institutes of Health [SIREN U54 HG007479, R01NS107900, R01NS107900-02S1, R01NS115944-01, 3U24HG009780-03S5, 1R01NS114045-01, 1R13NS115395-01A1, D43TW012030]
  5. Australian National Health and Medical Research Council
  6. National Heart Foundation of Australia Future Leader Fellowship
  7. WSO

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Stroke is a major global threat to life and disability, particularly in low- and middle-income countries that struggle to address its challenges. This article provides an overview of primary stroke prevention, estimating the cost and identifying deficiencies in guidelines and primary prevention approaches. Pragmatic solutions are offered, emphasizing the role of governments and population-wide strategies. Implementation of primary stroke prevention involves various stakeholders across the lifespan.
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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