What evidence is there to support the benefits of a healthy lifestyle and vascular risk factor control for the secondary prevention of ischemic stroke or TIA?
The evidence for the benefits of a healthy lifestyle and vascular risk factor control for the secondary prevention of ischemic stroke or TIA is supported by the INTERSTROKE study (Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries). This study found that 5 factors - BP, diet, physical inactivity, smoking, and abdominal obesity - accounted for 82% and 90% of the population-attributable risk (PAR) for ischemic and hemorrhagic stroke respectively. Similarly, the Global Burden of Disease Study showed that 90.5% (95% uncertainty interval, 88.5 92.2) of the global burden of stroke was attributable to modifiable risk factors. A modeling study also showed that targeting multiple risk factors such as aspirin, statin, and antihypertensive medications, combined with diet modification and exercise, can result in an 80% cumulative risk reduction in recurrent vascular events.