Prevention of stroke: a strategic global imperative

Key Points Although global stroke incidence and mortality declined from 1990 to 2013, the stroke burden, in terms of absolute numbers of people affected by stroke, continues to increase rapidly throughout the world The ever-increasing burden of stroke suggests that current primary prevention strategies for stroke and cardiovascular disease (CVD) are not sufficiently effective To improve primary stroke prevention strategies, we need to shift the emphasis from a high-risk approach to a more comprehensive approach targeting people at all levels of CVD risk To be cost-effective, primary stroke prevention strategies must be integrated with prevention strategies for other major noncommunicable diseases that share common risk factors with stroke, including CVD, vascular dementia and diabetes Resources for the development and implementation of culturally appropriate and population-specific primary stroke prevention strategies could be taken from revenue resulting from taxation on tobacco, salt, sugar and alcohol Given the already immense and fast-increasing burden of stroke and other major NCDs, which threatens global sustainability, failure to act on primary prevention of these diseases is unacceptable