What is the recommended first-line treatment for preventing recurrent strokes in high-risk patients?

Antiplatelet therapy is recognized as the recommended first-line treatment for preventing recurrent strokes in high-risk patients. This approach is primarily aimed at reducing the risk of future ischemic strokes. Antiplatelet agents, such as aspirin or clopidogrel, work by inhibiting platelet aggregation, thereby preventing the formation of blood clots that can obstruct blood flow to the brain.

The use of antiplatelet therapy is supported by evidence indicating that it significantly decreases the incidence of recurrent strokes, particularly in patients who have experienced a transient ischemic attack (TIA) or a first stroke. Guidelines consistently emphasize the importance of this therapy as a central component of secondary stroke prevention strategies.

While anticoagulation therapy is valuable for specific conditions such as atrial fibrillation or other cardiac sources of embolism, it is not standard first-line treatment for all high-risk patients, particularly those without these conditions. Statin therapy is important for managing cholesterol levels and providing cardiovascular protection, but it is not primarily focused on preventing recurrent stroke on its own. Blood pressure management is also crucial in stroke prevention, yet it operates more as a risk factor modification rather than a direct preventive measure for recurrent strokes.

Therefore, antiplatelet therapy stands out as the primary