Which are key components of secondary stroke prevention?

• A. Antiplatelet therapy, statin therapy, blood pressure control, diabetes management, smoking cessation, and lifestyle modification.
• B. Anticoagulation for all stroke patients regardless of etiology.
• C. Immunotherapy.
• D. Surgical intervention only.

Answer: (A)

Secondary stroke prevention focuses on reducing the chance of another stroke by addressing modifiable vascular risk factors and using therapies that protect the blood vessels. The most effective approach includes antiplatelet therapy to prevent further clotting in most non-cardioembolic strokes, statin therapy to lower and stabilize cholesterol and reduce atherosclerotic plaque risk, diligent blood pressure control, careful diabetes management, smoking cessation, and broad lifestyle changes such as regular exercise, healthy eating, and weight management. Each piece targets a different aspect of vascular health, and together they significantly cut recurrence risk.

Anticoagulation is not used for every stroke patient; it’s reserved for specific situations like atrial fibrillation or other cardioembolic sources where it lowers recurrence risk more effectively than antiplatelets. Immunotherapy doesn’t play a standard role in secondary prevention, and surgical interventions are not universal; they’re considered for particular problems (such as high-grade carotid stenosis) in addition to medical risk-factor management.