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Optimising secondary prevention in the acute period following a TIA of ischaemic origin
  1. Neil Heron1,2,3
  1. 1 Department of General Practice and Primary Care, Queen’s University, Belfast, UK
  2. 2 Centre for Public Health Research, Queen’s University, Belfast, UK
  3. 3 Centre of Excellence for Public Health Research, Queen’s University, Belfast, UK
  1. Correspondence to Dr Neil Heron; neilheron{at}


Background Transient ischaemic attacks (TIAs) are highly prevalent conditions, with at least 46 000 people per year in the UK having a TIA for the first time. TIAs are a warning that the patient is at risk of further vascular events and the 90-day risk of vascular events following a TIA, excluding events within the first week after diagnosis when the risk is highest, can be as high as 18%. Immediate assessment of patients with TIA, either at accident and emergency, general practice and/or TIA clinics, is therefore required to address secondary prevention and prevent further vascular events.

Discussion This article addresses the need for optimising secondary prevention in the acute period following a TIA of ischaemic origin to reduce the risk of further vascular events as per recent Cochrane review advice and presents a novel project, Stroke Prevention Rehabilitation Intervention Trial of Exercise (SPRITE), to do this.

Summary One novel way to tackle vascular risk factors and promote secondary prevention in patients with TIA could be to adapt a cardiac rehabilitation programme for these patients. SPRITE, a feasibility and pilot study ( Identifier: NCT02712385) funded by the National Institute for Health Research, is attempting to adapt a home-based cardiac rehabilitation programme, ‘The Healthy Brain Rehabilitation Manual’, for use in the acute period following a TIA. The use of cardiac rehabilitation programmes post-TIA requires further research, particularly within the primary care setting.

  • TIA
  • minor stroke
  • secondary cardiovascular prevention
  • cardiac rehabilitation
  • ‘The Healthy Brain Manual’.

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

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