Abstract Number: Esoc2026a1135 Secondary Ischaemic Stroke and Tia Prevention in Primary Care

Abstract Background and aims Recurrent stroke affects 9-15% of patients within one year and is largely driven by modifiable vascular risk factors. Although secondary prevention can substantially reduce recurrence by up to 80%, risk-factor control in the community remains suboptimal. ESO and NICE guidelines recommend strict targets for blood pressure, lipid and glycaemic control, alongside structured follow-up in primary care. This audit evaluated the quality of secondary stroke prevention in a primary care population, focusing on the aforementioned targets, smoking, and completion of a structured six-month review. Methods Retrospective audit of patients with a new diagnosis of ischaemic stroke or TIA within 2024 and 2025 at a general practice in London. Electronic records were reviewed for the most recent BP, LDL cholesterol and HbA1c, antithrombotic therapy, smoking status, and documentation of structured post-stroke follow-up. Results Twenty-five patients were identified. Blood pressure was not rechecked post-event in 8%; 48% met target levels, while 44% remained above target. LDL cholesterol was not assessed in 28%; 44% met targets and 28% did not. HbA1c was not reassessed in 28%; among those measured, 60% achieved target control and 12% had suboptimal control. Overall, 92% were prescribed antithrombotic therapy. Twelve percent were current smokers, and of 19 eligible patients, only 32% had received a structured post-stroke review. Conclusions Secondary stroke prevention in primary care remains suboptimal, with persistent gaps in blood pressure, lipid and glycaemic control, often without maximal tolerated therapy. Most patients did not receive a structured six-month review. Electronic alerts and standardised review templates may improve risk-factor optimisation and follow-up. Conflict of interest Maryam Haneef: nothing to disclose