Wasting Stroke Prevention Resources

See related article, p 1781.After the financial downturn of 2008, many governments and businesses were forced to cut costs and live in a new “age of austerity.” With regard to the provision of healthcare services, the age of austerity requires prioritizing healthcare needs and providing treatments that are demonstrably beneficial and in the ideal world, relatively inexpensive as well.So what are our current priorities for the primary prevention of stroke? Available options run the gamut from lifestyle factors that are virtually free (physical exercise), inexpensive (aspirin for select populations, generic statins/antihypertensives), and expensive (carotid endarterectomy [CEA] or more recently carotid artery stenting for selected patients with severe, asymptomatic stenosis).1In terms of both CEA and carotid artery stenting for asymptomatic stenosis, experienced clinicians recognize that both involve an upfront risk to the patient due to …