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Both the authors were involved in the writing of the manuscript and had final approval of the submitted and published versions. Funding: This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. Disclaimer: The views expressed in this article are those of the authors and not the English Department of Health or the National Institute for Health Research. Competing interests: None declared. Ethics approval: Ethical approval was obtained from the Oxford Research Ethics Committee (reference number 07/H0604/102). Provenance and peer review: Not commissioned; externally peer reviewed. Data sharing statement: No additional data are available.""Stroke killed 5.7 million people worldwide in 2005 and is estimated to cause 6.5 million deaths in 2015,1 with stroke survivors often being left with considerable disability.2 Many strokes are preceded by transient ischaemic attacks (TIAs) in the previous 90?days,3 and therefore the immediate period after a TIA is a crucial time to intervene to tackle the known vascular risk factors and reduce the risk of stroke. In 2006, approximately 1700 TIAs and 4000 strokes occurred in Northern Ireland alone.4 The 90-day risk of vascular events following a TIA or ��minor�� stroke, excluding events within the first week after diagnosis when the risk is highest, can be as high as 18%.5 The ABCD2 score (consisting of age, blood pressure, clinical symptoms, duration of symptoms and presence of diabetes) in patients with TIA is used to identify the future risk of stroke.3 The presence of a new infarct, identified on brain imaging and indicating that the patient has actually had a stroke rather than a TIA, places the patient at higher risk of a further stroke within the first 90?days.6 Secondary prevention reduces risk of second stroke Immediate assessment of TIA and ��minor�� stroke patients following the initial event, with initiation within 24 h of secondary prevention to tackle the known vascular risk factors, focused on pharmacological interventions, can reduce the 90-day risk of stroke to 2% within the research setting.7 Current guidelines however, recommend that patients should be assessed up to 1?week following a potential diagnosis,8 rather than within 24?h.7 Evidence is AZD6244 molecular weight growing regarding the contribution of change in modifiable vascular risk factors to reductions in cardiovascular deaths and there is a need to consider how to promote non-pharmacological measures within secondary prevention. Underlying pathological mechanism and risk factors for TIA/'minor�� stroke TIA and strokes are most commonly caused by the embolic or thrombotic consequences of atherothrombotic disease,9 which is similar to the underlying pathological mechanism for cardiovascular disease (CVD).