The patient population studied had increased access considering that they had received specialty care within the past year at a cardiology practice. However, even in this select population, there were barriers to optimal care. A proportion of women reported being unable to see a physician for a scheduled appointment in the past year because of cost. Whether this was a primary care visit or specialty visit was not reported. An even greater percentage was unable to take a medication because of cost in the past year. Efforts in education and increasing risk perception are undermined if high-risk populations are unable to obtain the advice or the medications that are essential to reducing their stroke risk factors. Surprisingly, perception of risk was not related to access to a physician or length of time since follow-up. This suggests that specialty physicians, treating conditions such as hypertension, diabetes, and heart disease, are not emphasizing patients’ stroke risk in clinical encounters.