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Session Chairs

• Ralph L. Sacco
• Karen L. Furie

Contact: Barbara Radziszewska

Start time 10:30 a.m.
End time 1:00 p.m.

Participants

Joseph P. Broderick
Larry Goldstein
Philip V. Gorelick
Jonathan Halperin
Robert Hart
George Howard
S. Claiborne Johnston
Walter Kernan
J. Philip Kistler
Rose Marie Robertson
Don Smith
Philip A. Wolf

Agenda

1. Statement of the Problem

1. Prevalence of vascular risk factors
2. Stroke Specific Risk Factors ( AF, carotid atherosclerosis)
3. Diet/Lifestyle and stroke risk
4. Established recommendations
   1. HTN
   2. DM
   3. Cholesterol
   4. Smoking
   5. AF
   6. CEA
5. Current compliance with recommendations is poor

2. Questions/Challenges/Barriers

1. Primary vs. Secondary prevention- should the focus be different?
2. Should targets vary by population?
3. What screening algorithms should be recommended?
4. How can physician and patient compliance be improved
5. What outcome measures should be used?

3. Research And Scientific Priorities (3)

1. Support research evaluating the dissemination, implementation and cost efficacy of stroke prevention clinical trial findings to the public and health care providers particularly focusing on ways of transmitting information to those at highest risk for stroke including minority populations.
2. To expand the number of potentially modifiable risk factors and define markers of pre-clinical disease to better identify stroke-prone individuals with particular emphasis on stratification by race/ethnic group.
3. Support the development of studies evaluating the effectiveness of behavior modification specifically in of a focused program of early stroke prevention in the setting of a structured healthcare system
4. To identify surrogate endpoints to evaluate the efficacy of stroke prevention interventions in clinical trials with the aim of implementing earlier interventions.
5. To define the relationship between stroke risk factors, prognosis and functional outcome and investigate interventions to improve stroke outcomes in different racial/ethnic populations
6. To examine the use of multi-risk factor assessment tools to identify patient populations warranting aggressive risk factor ( i.e. DM, HTN,cholesterol) management and intervention with medical therapy (statins, ACE inh, antiplatelet therapy) for primary and secondary stroke prevention

4. Resources Needed (preliminary)

1. Resources to establish a national stroke registry
2. DNA microarrays for stroke
3. Increased research funding of epidemiological studies and clinical trials in stroke prevention
4. Partnering with the private sector to increase access to services to facilitate lifestyle modification (dietary counseling, weight loss, exercise)
5. Foster collaborations with healthcare organizations to implement early stroke prevention programs
6. Resources to improve measurement of stroke outcome

Last updated February 09, 2005