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 .
Clinical features and racial/ethnic differences among the 3020 participants in the Secondary Prevention of Small Subcortical Strokes (SPS3) trial.
This study examined the baseline characteristics , racial/ethnic differences , and geographic differences among participants in the Secondary Prevention of Small Subcortical Strokes ( SPS3 ) study . The SPS3 trial enrolled patients who experienced a symptomatic small subcortical stroke ( lacunar stroke ) within the previous 6 months and an eligible lesion on detected on magnetic resonance imaging . The patients were r and omized , in a factorial design , to antiplatelet therapy ( aspirin 325 mg daily plus clopidogrel 75 mg daily vs aspirin 325 mg daily plus placebo ) and to one of two levels of systolic blood pressure targets ( " intensive " [ < 130 mmHg ] or " usual " [ 130 - 149 mmHg ] ) . A total of 3020 participants were recruited from 81 clinical sites in 8 countries . In this cohort , the mean age was 63 years , 63 % were men , 75 % had a history of hypertension , and 37 % had diabetes . The racial distribution was 51 % white , 30 % Hispanic , and 16 % black . Compared with white subjects , black subjects were younger ( mean age , 58 years vs 64 years ; P < .001 ) and had a higher prevalence of hypertension ( 87 % vs 70 % ; P < .001 ) . The prevalence of diabetes was higher in the Hispanic and black subjects compared with the white subjects ( 42 % and 40 % vs 32 % ; both P < .001 ) . Tobacco smoking at the time of qualifying stroke was much more frequent in the Spanish participants than in subjects from North America and from Latin America ( 32 % , 22 % , and 9 % , respectively ; P < .001 ) . Mean systolic blood pressure at study entry was 4 mmHg lower in the Spanish subjects compared with the North American subjects ( P < .01 ) . The SPS3 cohort is the largest magnetic resonance imaging-defined series of patients with S3 . Among the racially/ethnically diverse SPS3 participants , important differences in patient features and vascular risk factors could influence prognosis for recurrent stroke and response to interventions
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 .