Identification of precursors of stroke is the first step in instituting a program for disease prevention. These precursors include risk factors: hypertension, diabetes, cigarette smoking, left ventricular hypertrophy by ECG, as well as predisposing diseases: coronary heart disease, cardiac failure and atrial fibrillation. Two preventive approaches may be taken: one is a public health approach whereby the entire population is informed of the dangers of certain highly prevalent risk factors for disease: antismoking and hypertension awareness campaigns and the current United States National Cholesterol Education Program are examples of this approach; the other is more focused and requires treatment by physicians of individuals found to be at increased risk of stroke. For the public health approach to be feasible, the risk factor under attack needs to be prevalent in the population and potent as a disease promotor. For precursors occurring infrequently in the population but with a high relative risk, or where the multiple borderline levels of risk factors are present, treatment of high risk individuals is in order. Use of the stroke risk function enables the treating physician to determine the conditional probability of stroke in the individual patient. The individual''s risk of stroke can be compared to that of an average person of the same age and sex and has been shown to be useful in predicting stroke recurrence and death.

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