AHA/ASA Stroke Council member and volunteer expert, Larry B. Goldstein, M.D., offers perspective (via Skype) on ISC 20 presentation 154. He is Chair, Department of Neurology; Co-Director, Kentucky Neuroscience Institute, UK HealthCare, Lexington, KY.
copyright American Heart Association 

"Portion of the increased stroke risk that we're finding in the country now. Remember that over about three decades, stroke-related mortality in the country had been declining, and declining relatively rapidly. But over the last few years, that's actually leveled off, and over the last few years, from 2015 onward, in some areas of the country, about three out of four states, stroke-related mortality has actually either stalled or increased. A good portion of that, we believe, is from poor control of risk factors. This narrows the epidemic in both diabetes and obesity. So, one important message is to do things to try to lower the risk of developing diabetes, and developing these complications to begin with. That's why following a healthy lifestyle is so important. Type 2 diabetes, which is the primary form of diabetes that's associated with these adverse effects, is also associated with development of obesity, having a sedentary lifestyle. And compounding that, when one has a high blood pressure, smokes, drinks alcohol to excess, that further increases the risk of vascular complications. So, the message, if anything, is similar to one that we try to make over and over again; the best way to treat a stroke is never to have one to begin with. So, prevention is paramount. And there are lots of things people can do to try to reduce their risk of even developing the risk factors that then lead to disease."