The risk factors for stroke are well established, as are the steps needed to preventsecondary strokes. Yet there remains a substantial divide between what is known in theory, and the extent to which those risks are reduced in the real world. The reasons for this divide include a lack of awareness of the signs of stroke, a lack of knowledge about modifiable risk factors on the part of patients, a lack of prevention programmes in hospitals and in the community, and poor utilisation of existing programmes. Now, a team of stroke specialists at the University of California at Los Angeles (UCLA) Medical Center, US, has developed a formalised, post-discharge treatment programme which they say will provide integrated, methodical and effective follow-up throughout the first year after a patient's stroke. Maintaining such a structured programme, the researchers believe, would help reduce the risk of subsequent events by closing some of the practice-gap between what physicians know and what information gets passed on to the patient.