Exploring interventions in secondary stroke prevention: a case study

Stroke remains the third leading cause of death in the UK after coronary heart disease and cancer, and the main cause of adult disability in the western world (Bonita, 1992). Unfortunately, for those people who suffer a recurrent stroke, outcomes are poorer than for those after a first stroke (Lee et al, 2004). The Royal College of Physicians (2004: 40) recommend: ‘An individual strategy for stroke prevention should be implemented within a maximum of seven days of acute stroke or transcient ischaemic attack.’ This paper explores the evidence base for interventions in secondary stroke prevention. Risk factors for stroke are outlined, the role of anti-platelet therapy is discussed, and pharmacological strategies in the management of hyperglycaemia, hyperlipidaemia and hypertension are examined. The risk factor of cigarette smoking is also addressed. Collaborative goal setting and care planning is a central tenet of this case study, with the patient enabled to make informed life-style changes.