Stroke is a leading cause of disability and mortality in the United States and other industrialized countries. This chapter discusses important issues that arise in the enumeration of stroke and how differences betweens studies can often be explained by differences in diagnostic or case definition criteria. It describes geographic variations in stroke incidence and mortality, and summarizes a vast literature on stroke risk factors. The chapter is split into two primary sections: ischemic stroke and hemorrhagic stroke and, for each stroke type, non-modifiable risk factors (i.e., genetics, age, sex, race/ethnicity) and modifiable risk factors (smoking, diet, physical activity, hypertension) are discussed. Based on the estimated prevalence of risk factors and their attributable risk for stroke in the United States, it is estimated that a significant proportion of strokes could be prevented through the control of modifiable stroke risk factors. Therefore, part of the chapter is devoted to the design of studies of primary and secondary prevention, and to studies identifying predictors of stroke recurrence.
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