Patients with diabetes have an increased risk for stroke. 2 RCTs have shown that tight glucose control in patients with type 1 diabetes and intensive drug use in patients with type 2 diabetes reduce microvascular complications but not macrovascular complications, such as stroke. Asymptomatic carotid artery disease. Risk for stroke increases with increasing carotid stenosis. Existing guidelines do not uniformly support endarterectomy for asymptomatic stenosis.
Risk is proportional to the number of cigarettes smoked.
Light or moderate alcohol consumption may protect against ischemic stroke, but heavy alcohol use increases the risk for hemorrhagic stroke. Regular exercise reduces the risk for premature death and cardio-vascular disease. The protective effect of exercise may be mediated by other risk factors. Recommendations include promotion of smoking cessation, regular exercise, moderate alcohol use, and a healthy diet. Conclusions Several interventions reduce the incidence of a first stroke by modifying risk factors.