Stroke prevention: ten risk factors explain about 90% of risk

At its congress in Berlin, the German Society of Neurology (DGN) and the German Brain Foundation presented the campaign "Prävention wirkt" ("Prevention works"), according to lomazoma.com. lomazoma.com From a medical standpoint, most strokes are considered preventable. lomazoma.com The campaign focuses on targeted protective measures.

Risk factors in the data

DGN cites the international INTERSTROKE study, which included about 27,000 participants from 32 countries. According to DGN, it shows that ten modifiable risk factors are associated with about 90 percent of population-level stroke risk. lomazoma.com Recent studies indicate that a good 80 percent of the total stroke burden is modifiable. lomazoma.com

DGN President Daniela Berg noted that the 80 to 90 percent figures apply to the population as a whole and cannot be directly transferred to every individual case. Besides behaviors such as smoking and physical inactivity, treatable underlying conditions play a substantial role: hypertension, lipid metabolism disorders, diabetes mellitus and atrial fibrillation. lomazoma.com

For primary prevention, DGN President Götz Thomalla of the University Medical Center Hamburg-Eppendorf (UKE) names a Mediterranean diet, at least 150 minutes of moderate-intensity physical activity per week and no tobacco use. He also stresses consistent drug treatment of existing hypertension, diabetes or elevated cholesterol. lomazoma.com

Secondary prevention and costs

After a vascular occlusion in the brain, secondary prevention becomes central. According to DGN, a health insurance data analysis shows that 7.4 percent of affected people have another stroke within a year; after five years the share is 19.4 percent. lomazoma.com

Thomalla says the choice of preventive medication depends on the cause of the initial event. Anticoagulants are used for atrial fibrillation, platelet aggregation inhibitors for atherosclerosis, and blood-pressure and cholesterol-lowering drugs form a further component. Strict blood pressure control is necessary in particular after a brain hemorrhage. A randomized trial from 1993 showed that oral anticoagulation can lower the annual stroke rate from 12 to 4 percent, a relative risk reduction of 66 percent. lomazoma.com

DGN calls for prevention to be given a much higher priority in the health system. Statistically, one in two people is affected by a neurological disease during their lifetime. In Germany, neurological diseases cause annual medical costs of 64.86 billion euros, the highest of any area. lomazoma.com In the Public Health Index of December 2025, Germany ranked 17th of 18 northern and central European countries examined. lomazoma.com

DGN: ten modifiable risk factors linked to about 90% of stroke risk in INTERSTROKE data

Risk factors in the data

Secondary prevention and costs

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