American Heart Association Prevention Conference IV: Prevention and Rehabilitation of Stroke Introduction

The fourth American Heart Association Prevention Conference was held May 1-2, 1996, in Tucson, Ariz. This report of the conference presents the state of knowledge on stroke epidemiology, etiologic basis, treatment, and rehabilitation. Since the conference, enthusiasm for and activity in acute stroke treatment has increased, spurred by the encouraging and successful National Institutes of Health trial of tissue plasminogen activator (TPA). This document attests to the large variety of conditions that contribute to stroke. The challenge for the future will be to forge a better understanding of the interaction of pathogenic risk factors, causes, and physiology. Evidence-based medicine should provide a scientific framework that can be used in the prevention and treatment of stroke in individual patients. The untimely death of Dr Mike Pessin, who chaired the Acute Interventions panel, has deeply saddened all of us. His presence and contributions will be sorely missed. We thank the section chairs and panel members who contributed many hours and their expertise to the preparation of this paper. We are indebted to the American Heart Association, which contributes to the dominant and driving force in stroke research and treatment. Mark L. Dyken, MD The best treatment for stroke is prevention. If stroke cannot be prevented, the next best treatment is to prevent permanent deficit. AHA Prevention ConferenceIV is dedicated to the prevention and rehabilitation of stroke, with an emphasis on risk factors, etiology, acute intervention, and rehabilitation. Leaders in the field will define where we are and where we need to go. To put this in perspective, the evolution of properly designed studies, the recognition of risk factors, and the evidence that risk factors can be altered must be reviewed. No matter how sophisticated the design and statistical techniques, all studies must have the same fundamentals: There must be a testable hypothesis, …

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