Secondary Prevention: Aligning Treatment Goals and Patient Adherence

In this episode, titled ‘Secondary Prevention: Aligning Treatment Goals and Patient Adherence,’ the neurology experts explored the following critical questions:

What are the overall treatment goals for patients with ischemic stroke?

What are the key lifestyle and risk management steps that patients should take to prevent recurrent ischemic stroke?

The neurology experts examined the shifting priorities from acute intervention to chronic secondary prevention, with a primary focus on the "do no harm" principle through bleeding risk mitigation. Andrew Russman and Danison Emmerson emphasized that while acute treatment varies little across stroke subtypes, chronic management requires "individualized algebra" to balance comorbidities and medication adherence. The panel detailed specific lifestyle prescriptions, including a target blood pressure of less than 130/80 mmHg and a low-salt Mediterranean or DASH diet. Furthermore, the conversation highlighted the role of statins, PCSK9 inhibitors, and physical activity in achieving aggressive LDL targets to reduce the risk of a recurring event.

Throughout the conversation, the experts provide a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

In the next episode, ‘Beyond the Hospital Walls: Optimizing Transitions of Care and Long-Term Management’, panelists will continue their discussion on stroke and highlight the distinct pharmacologic mechanisms of DOACs and antiplatelet therapies, as well as the critical 72-hour post-discharge window for transitional care.