• Jeyaraj D Pandian, Seana L Gall, Mahesh P Kate, Gisele S Silva, Rufus O Akinyemi, Bruce I Ovbiagele, Pablo M Lavados, Dorcas B C Gandhi, and Amanda G Thrift.
• Department of Neurology, Christian Medical College and Hospital, Ludhiana, India. Electronic address: jeyarajpandian@hotmail.com.
• Lancet. 2018 Oct 6; 392 (10154): 1269-1278.

AbstractAlong with the rising global burden of disability attributed to stroke, costs of stroke care are rising, providing the impetus to direct our research focus towards effective measures of stroke prevention. In this Series paper, we discuss strategies for reducing the risk of the emergence of disease (primordial prevention), preventing the onset of disease (primary prevention), and preventing the recurrence of disease (secondary prevention). Our focus includes global strategies and campaigns, and measurements of the effectiveness of worldwide preventive interventions, with an emphasis on low-income and middle-income countries. Our findings reveal that effective tobacco control, adequate nutrition, and development of healthy cities are important strategies for primordial prevention, whereas polypill strategies, use of mobile technology (mHealth), along with salt reduction and other dietary interventions, are effective in the primary prevention of stroke. An effective collaboration between various health-care sectors, government policies, and campaigns can successfully implement secondary prevention strategies, through surveillance and registries, such as the WHO's non-communicable diseases programmes, across high-income and low-income countries.Copyright © 2018 Elsevier Ltd. All rights reserved.

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