While lifestyle changes are crucial, they may not be enough on their own to protect our brains and prevent strokes¹. For stroke survivors, the effects of stroke can make it challenging for someone to maintain long-term lifestyle changes, in these circumstances, medication can be important for ongoing prevention (Bailey 2016). Those who do not follow their medication programme have a significantly higher risk of experiencing another stroke within one year, even if they make lifestyle changes².

Guidelines advise starting prevention medication at the time of stroke diagnosis. For example, after an ischaemic stroke, antiplatelets that prevent blood clots are recommended for prevention of another ischemic stroke or TIA to reduce the risk of stroke and other vascular events by 22%^3,4. Managing conditions such as high blood pressure, high cholesterol, diabetes, and atrial fibrillation (AF) with medication is crucial for stroke survivors³. It is essential that we follow the medications prescribed. For example:

Managing high blood pressure, which affects 50-80% of stroke survivors, can lower the risk of another stroke by 25-30% if properly controlled^4,5. However, even where 80-90% of survivors receive treatment, less than 40% reach the recommended blood pressure level^6,7.

• Up to 24% of stroke survivors are diagnosed with AF after their initial stroke⁸. Treating AF with anticoagulants can reduce the risk of secondary stroke by 60 to 70%⁹. Although anticoagulation therapy is accepted as gold standard for reducing the risk of stroke, major challenges are underuse, underdosing and people not following their treatment programme¹⁰.
• Managing diabetes and obesity, which affects 26%¹¹ and 18-25%^12,13 of stroke survivors, respectively, can lower risk of stroke. Treatments for diabetes include insulin, metformin, and GLP-1s (glucagon-like peptide 1 receptor agonists, which many people refer to as “weight loss injections”)¹⁴. Treatments for obesity include GLP-1s. Access to GLP-1s varies between countries. For example, in the UK, eligibility depends on meeting specific criteria related to body mass index and cardiovascular disease¹⁵.

For more detailed information on managing stroke risk through medication and surgery, please refer to the section on medical interventions

Read about medical interventions

Read about surgical interventions