Improving Access to Primordial and Primary Stroke Prevention: Global Considerations

Stroke is the second‐leading cause of death and the third‐leading cause of disability worldwide. Low‐ and middle‐income countries continue to experience an increase in stroke incidence despite scientific advances to prevent strokes. In this topical review, we provide an overview of primordial and pr...

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Main Authors: Nada El Husseini, Michelle Nichols, Mayowa Owolabi
Format: Article
Language:English
Published: Wiley 2025-08-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
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Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.124.040119
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author Nada El Husseini
Michelle Nichols
Mayowa Owolabi
author_facet Nada El Husseini
Michelle Nichols
Mayowa Owolabi
author_sort Nada El Husseini
collection DOAJ
description Stroke is the second‐leading cause of death and the third‐leading cause of disability worldwide. Low‐ and middle‐income countries continue to experience an increase in stroke incidence despite scientific advances to prevent strokes. In this topical review, we provide an overview of primordial and primary prevention strategies and present actionable practices that may improve access to stroke prevention including policies and population‐wide strategies, such as task‐shifting and sharing and health system reengineering. Most strokes can be prevented through primordial prevention defined as the avoidance of the emergence of risk factors and primary prevention defined as effective management of risk factors. Primordial and primary stroke prevention strategies are predominantly behavioral (eg, smoking and recreational drug avoidance or cessation, physical activity, healthy diet) and pharmacological (eg, medications that control risk factors such as diabetes, hypertension, or cholesterol). However, access to primordial and primary stroke prevention is variable and affected by multiple social and commercial determinants of the health of individuals as well as the environments in which they live, cultural considerations, and the policies that govern these environments. In light of emerging novel risk factors such as mental stressors, air pollutants, diet types, and risk factors specific to women, additional societal, individual, health care professionals, funders, and health system efforts should be mobilized for equitable and effective implementation of stroke prevention.
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spelling doaj-art-eec8064fb181421d8fcfefb5962809632025-08-20T07:25:08ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-08-01141610.1161/JAHA.124.040119Improving Access to Primordial and Primary Stroke Prevention: Global ConsiderationsNada El Husseini0Michelle Nichols1Mayowa Owolabi2Department of Neurology Duke University Durham NC USACollege of Health Professions Medical University of South Carolina Charleston SC USACenter for Genomics and Precision Medicine College of Medicine, University of Ibadan NigeriaStroke is the second‐leading cause of death and the third‐leading cause of disability worldwide. Low‐ and middle‐income countries continue to experience an increase in stroke incidence despite scientific advances to prevent strokes. In this topical review, we provide an overview of primordial and primary prevention strategies and present actionable practices that may improve access to stroke prevention including policies and population‐wide strategies, such as task‐shifting and sharing and health system reengineering. Most strokes can be prevented through primordial prevention defined as the avoidance of the emergence of risk factors and primary prevention defined as effective management of risk factors. Primordial and primary stroke prevention strategies are predominantly behavioral (eg, smoking and recreational drug avoidance or cessation, physical activity, healthy diet) and pharmacological (eg, medications that control risk factors such as diabetes, hypertension, or cholesterol). However, access to primordial and primary stroke prevention is variable and affected by multiple social and commercial determinants of the health of individuals as well as the environments in which they live, cultural considerations, and the policies that govern these environments. In light of emerging novel risk factors such as mental stressors, air pollutants, diet types, and risk factors specific to women, additional societal, individual, health care professionals, funders, and health system efforts should be mobilized for equitable and effective implementation of stroke prevention.https://www.ahajournals.org/doi/10.1161/JAHA.124.040119globalprimary preventionprimordial preventionstroke
spellingShingle Nada El Husseini
Michelle Nichols
Mayowa Owolabi
Improving Access to Primordial and Primary Stroke Prevention: Global Considerations
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
global
primary prevention
primordial prevention
stroke
title Improving Access to Primordial and Primary Stroke Prevention: Global Considerations
title_full Improving Access to Primordial and Primary Stroke Prevention: Global Considerations
title_fullStr Improving Access to Primordial and Primary Stroke Prevention: Global Considerations
title_full_unstemmed Improving Access to Primordial and Primary Stroke Prevention: Global Considerations
title_short Improving Access to Primordial and Primary Stroke Prevention: Global Considerations
title_sort improving access to primordial and primary stroke prevention global considerations
topic global
primary prevention
primordial prevention
stroke
url https://www.ahajournals.org/doi/10.1161/JAHA.124.040119
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