What is the best strategy to prevent additional strokes?
The best strategy depends on the causative etiology: options for carotid stenosis, intracranial stenosis, and atrial fibrillation are presented below. Small vessel disease secondary stroke prevention relies solely on aggressive risk factor management.
Goals for secondary stroke prevention include target blood pressure <140/90, antiplatelet or anticoagulant as appropriate, statin, hemoglobin A1C <7, smoking cessation, regular exercise, and BMI <25.
Obstructive sleep is associated with increased stroke risk independent of its association with hypertension, so treatment seems prudent.