The value of stroke prophylaxis

Primary prevention of stroke goes along two lines. By mass strategy society promotes healthier life styles and by high risk strategy individuals with certain risk factors are indentified and specific prophylactic measures ins tituted. Treatment of arterial hypertension reduces stroke risk. Antihypert ensive treatment by diuretics is more cost effective than other antihyperte nsive drugs, and more so in the elderly than in the middle aged. In patient s with non-vascular atrial fibrillation (NVAF) and a high risk of ischaemic stroke anticoagulation is cast saving provided the frequency of intracereb ral haemorrhage is low. In low risk NVAF patients aspirin is to be preferre d, both clinically and economically. In secondary stroke prevention in pati ents without a cardioembolic source aspirin as well as the combination of a spirin and dipyridamole are cost saving. Eur J Neurol 6 (suppl 2):S25-S29 ( C) 1999 Lippincott Williams & Wilkins.