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Practice Recommendations: Secondary Prevention

Recommendation	Level of Evidence
1.0 Nurses in all practice settings should screen clients for risk factors related to stroke in order to facilitate appropriate secondary prevention. Clients with identified risk factors should be referred to trained healthcare professionals for further management.	IV

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Commonly accepted risk factors for Stroke

Risk factors for stroke include modifiable, non-modifiable and probable factors. The following table summarizes the commonly accepted risk factors for stroke:

• Modifiable
• Non–modifiable
• Probable

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Modifiable 

• Hypertension
• Diabetes Mellitus
• Hyperlipidemia
• Smoking
• Sedentary lifestyle
• Overweight
• Atrial fibrillation
• Coronary artery disease
• Cardiac disease
• Previous stroke
• Previous TIA
• Asymptomatic carotid stenosis
• Peripheral vascular disease
• Atherosclerosis
• Coagulation disorders
• Hormone replacement therapy

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Non-modifiable 

• Age
• Family history
• Male sex
• Ethnicity
• Heredity
• Socioeconomic status

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Probable 

• Drug & alcohol abuse
• Stress
• Sleep apnea
• Migraine headache
• Oral contraceptive use
• Congenital cardiac anomalies
• Elevated homocysteine levels
• Sympathomimetic agents

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