[Possibilities of primary prevention of stroke: elaboration of a population level strategy].

This review is devoted to principles of primary prevention of cerebral stroke. Prevalence of stroke and its contribution to development of complications and lethal outcomes is analyzed in detail. Main principles of prevention of stroke are delineated and contemporary international guidelines on correction risk factors (arterial hypertension, smoking, disorders of lipid metabolism, diabetes mellitus, atrial fibrillation) are reviewed. Special attention is given to the significance of asymptomatic stenoses of carotid arteries as predictors of stroke and to modern methods of diagnosis and treatment of such stenoses. Expediency of the use of hormonal replacement therapy with the aim of stroke prevention in postmenopausal women is considered. It is noted that antiaggregant therapy and specifically acetyl salicylic acid should be administered only in the presence of high risk of cardiovascular complications. The authors believe that overall success of stroke prevention depends on realization of complex long term national programs.