Both symptomatic and asymptomatic atherosclerosis significantly increase the risk of major vascular events within five years of a TIA or minor ischaemic stroke, shows a large cohort study.

The findings suggest an almost three times higher risk in patients with large artery atherosclerosis, and the novel finding of a near two-fold greater risk among those with asymptomatic atherosclerosis.

International researchers, including University of Melbourne neurologist Professor Geoffrey Donnan, say further reductions in long-term stroke risk could be achieved with more “aggressive” control of atherosclerosis in targeted patients.

“Preventive strategies … should focus on individuals with atherosclerosis rather than grouping together all people who have had a TIA or minor ischaemic stroke,” they concluded.