There were no significant effects of organisational  interventions on lipid profile , HbA1c , medication adherence or recurrent cardiovascular events .
Pooled results indicated that educational interventions were not associated with clear differences in any of the review outcomes .
The estimated effects of organisational interventions were compatible with improvements and no differences in several modifiable risk factors .
BACKGROUND People with stroke or transient ischaemic attack ( TIA ) are at increased risk of future stroke and other cardiovascular events .
Evidence -based strategies for secondary stroke prevention have been established .
However , the implementation of prevention strategies could be improved .
OBJECTIVES To assess the effects of stroke service interventions for implementing secondary stroke prevention strategies on modifiable risk factor control , including patient adherence to prescribed medications , and the occurrence of secondary cardiovascular events .
How Well Are Hypertension, Hyperlipidemia, Diabetes, and Smoking Managed After a Stroke or Transient Ischemic Attack?
Background and Purpose — Stroke prevention clinics ( SPCs ) are not usually involved with the active management of hypertension , hyperlipidemia , diabetes , and smoking . The effect of consultations generated at SPCs on the adequacy of the management of these risk factors for stroke has not been well described , and few studies have long-term follow-up . Methods — We performed a prospect i ve study of 119 consecutive patients referred to an SPC for secondary prevention .  One year after their baseline visit , patients were re-evaluated for the adequacy of the management of the above risk factors , and the proportion of improvement was assessed . Results — One-hundred twelve patients returned for their 1-year follow-up visit . Sixty-six were male , and the average age was 65 years . Hypertension was present in 83 patients , hyperlipidemia in 92 , diabetes in 26 , and smoking in 38 , and 80 had multiple risk factors . At baseline , 66 % of patients with hypertension , 17 % of patients with hyperlipidemia , and 23 % of diabetics had adequate management of their respective risk factors . During 1 year of follow-up , hypertension management improved 20 % ( P < 0.001 ) and lipid management improved 32 % ( P < 0.001 ) . There was no significant improvement in diabetes management or smoking cessation . Conclusions — Although our underst and ing of the benefit of addressing hypertension , hyperlipidemia , diabetes , and smoking for secondary prevention of stroke is evolving , we found marked room for improvement in the management of these four risk factors . SPCs may need to be more actively involved in the management of these modifiable risk factors , if we are to significantly impact the risk of recurrent stroke
There were no significant effects of organisational  interventions on lipid profile , HbA1c , medication adherence or recurrent cardiovascular events .
Pooled results indicated that educational interventions were not associated with clear differences in any of the review outcomes .
The estimated effects of organisational interventions were compatible with improvements and no differences in several modifiable risk factors .
BACKGROUND People with stroke or transient ischaemic attack ( TIA ) are at increased risk of future stroke and other cardiovascular events .
Evidence -based strategies for secondary stroke prevention have been established .
However , the implementation of prevention strategies could be improved .
OBJECTIVES To assess the effects of stroke service interventions for implementing secondary stroke prevention strategies on modifiable risk factor control , including patient adherence to prescribed medications , and the occurrence of secondary cardiovascular events .