Honoring World Stroke Day: Insights on Systemic Stroke Risk and Prevention Strategies

In recognition of World Stroke Day 2025, held annually October 29^th, NeurologyLive^® spoke with Andrew Russman, DO, Head of the Stroke Program and Medical Director of the Comprehensive Stroke Center at the Cleveland Clinic, about key priorities in stroke prevention and care. In the discussion, Russman underscored the importance of continued awareness efforts to help people recognize symptoms and seek treatment quickly, while also emphasizing that most strokes stem from identifiable and modifiable risk factors.

He highlighted how emerging precision medicine approaches, such as genotype-guided prevention, are beginning to shape individualized care and improve response to therapies like statins and anticoagulants. Lastly, he discussed how deepening collaboration between cardiologists and neurologists can optimize management of shared vascular risks—particularly atrial fibrillation—and strengthen prevention strategies across the heart–brain continuum.

NeurologyLive: What is the significance of World Stroke Day and how can we continue to spread awareness for stroke?

Andrew Russman, DO: We need to raise awareness among people worldwide that every minute counts in stroke treatment, and every individual can play a part in raising awareness of stroke symptoms and risk factors.

With more data emerging on shared vascular risk factors, how should clinicians approach stroke as a systemic vascular disease rather than an isolated neurological event?

Stroke happens for a reason.In the majority of patients we are able to identify risk factors and specific causes which lead to directed and individualized prevention strategies. Hypertension, diabetes, high cholesterol, smoking, atrial fibrillation are just a few of the important risk factors which when modified through medication and other treatment, significantly reduce the risk of both for stroke and secondary stroke

How might precision medicine, such as biomarker-guided or genotype-based risk stratification, reshape stroke prevention in the next decade?

Precision medicine utilizing genotype based risk stratification is already starting to reshape how we approach stroke prevention.By understanding specific gene types we can utilize specific medications such as statins more effectively, identify responders to specific blood thinning medications, and maximize the benefit of individualized prevention strategies

How do cardiology and neurology intersect most effectively in stroke care, and where are we still falling short?

Cardiologist and neurologist need to work in partnership and recognize the heart brain connection which when treated effectively, can have a significant impact on reducing stroke.Combined medication and device related strategies to reduce stroke in atrial fibrillation, especially among those with brain bleeding risk, depend on the effective partnership between cardiology and neurology.