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 .
Achieved blood pressures in the secondary prevention of small subcortical strokes (SPS3) study: challenges and lessons learned.
BACKGROUND Lowering blood pressure ( BP ) after stroke remains a challenge , even in the context of clinical trials . The Secondary Prevention of Small Subcortical Strokes ( SPS3 ) BP protocol , BP management during the study , and achieved BPs are described here . METHODS Patients with recent symptomatic lacunar stroke were r and omized to 1 of 2 levels of systolic BP ( SBP ) targets : lower : < 130 mm Hg , or higher : 130 - 149 mm Hg . SBP management over the course of the trial was examined by race/ethnicity and other baseline conditions . RESULTS Mean SBP decreased for both groups from baseline to the last follow-up , from 142.4 to 126.7 mm Hg for the lower SBP target group and from 143.6 to 137.4 mm Hg for the higher SBP target group . At baseline , participants in both groups used an average of 1.7±1.2 antihypertensive medications , which increased to a mean of 2.4±1.4 ( lower group ) and 1.8±1.4 ( higher group ) by the end- study visit . It took an average of 6 months for patients to reach their SBP target , sustained to the last follow-up . Black participants had the highest proportion of SBP ≥150 mm Hg at both study entry ( 40 % ) and end- study visit ( 17 % ) , as compared with whites ( 9 % ) and Hispanics ( 11 % ) . CONCLUSIONS These results show that it is possible to safely lower BP even to a SBP goal < 130 mm Hg in a variety of patients and setting s , including private and academic centers in multiple countries . This provides further support for protocol -driven care in lowering BP and consequently reducing the burden of 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 .