Stroke services addressing secondary prevention aim to improvepatient compliance with medication regimens and l ifestyle advice.Several classes of medication reduce stroke incidence by modify-ing cardiovascular risk. For example, long-term antiplatelet med-ication in those with a history of stroke or TIA is associatedwith a significant 25% reduction in secondary vascular events(Antithrombotic Trialists’ Collaboration 2002). Similarly, antihy-pertensive and statin medications are associated with improve-ments in secondary prevention (Manktelow 2009; Rashid 2003).Meta-analyses report that moderate to high physical activity (Lee2003), moderate alcohol consumption (Reynolds 2003), reduc-tion of salt intake (He 2004) and specific dietary changes (He2004a; He 2006 ) can also facilitate stroke prevention and cardio-vascular risk reduction. An international case-control study identi-fied five modifiable risk factors accounting for 83% of the popula-tion attributable risk (PAR) for stroke (O’Donnell 2010). Target-ing multiple risk factors may have additive benefits for secondaryprevention; a modelling study predicted that an 80% cumulative