Implementation of stroke prevention: a review of challenges and opportunities in the Americas.

Martins, Sheila O; Ordunez, Pedro; Borelli, Wyllians Vendramini; Ovbiagele, Bruce; Urrutia, Victor C; Abanto, Carlos; Alet, Matias J; Almarie, Bassel et al. · Lancet Reg Health Am · 2026

review · Level V

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Abstract

Stroke remains a leading cause of death and disability throughout the Americas, disproportionately impacting low-and middle-income countries and underserved populations. In this review, we examine the status of stroke prevention in the Americas. Prevention is essential, yet unequal access to healthcare has led to major disparities - especially among rural populations, ethnic minorities, and lower socioeconomic status. Models like the WHO HEARTS Program demonstrate that evidence-based programs can be tailored to local contexts. Telehealth and digital tools play a critical role in empowering patients, educating communities, and supporting healthcare workers. Despite growing efforts, challenges persist due to health inequities, gaps between policy and implementation, and underinvestment. Strengthening prevention will support countries in achieving the United Nations Sustainable Development Goals, targeting a one-third reduction in premature deaths from non-communicable diseases by 2030. This paper outlines effective strategies for implementing stroke prevention, emphasizing healthy lifestyles, early detection of risk factors, and system-level interventions.