{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:52:35Z","timestamp":1787017955526,"version":"build-2736575974"},"reference-count":79,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cerebrovasc Dis"],"abstract":"<jats:p>Introduction: Existing guidelines lack comprehensive recommendations for stroke prevention. This network meta-analysis aimed to evaluate the comparative efficacy of non-pharmacological interventions in preventing total stroke and fatal stroke in high-risk adults. Methods: We pooled only randomized controlled trials (RCTs). Relative risks (RRs), 95% confidence intervals (CIs), and P scores were computed to compare and rank the efficacy of interventions in preventing stroke. Results: 50 RCTs with 673,624 participants were pooled in this study. Compared with the control group, Exercise + Education may decrease stroke risk (RR = 0.23; 95% CI: 0.07\u20130.73; low strength of evidence [SOE]), followed by Exercise (RR = 0.40; 95% CI: 0.28\u20130.57; moderate SOE), Mediterranean diet (RR = 0.70; 95% CI: 0.50\u20130.97; low SOE), and Vitamin B6 combined with B12 and folic acid (Vitamin B6 + B12 + folic acid) (RR = 0.86; 95% CI: 0.77\u20130.95; moderate SOE). Only Salt substitute showed significantly reduced fatal stroke risk (RR = 0.78; 95% CI: 0.68\u20130.90; high SOE). Exercise + Education (low SOE) and Exercise alone (moderate SOE) showed short-term benefits on preventing stroke, while Salt substitute had long-term effects on reducing fatal stroke risk (high SOE). Carotid endarterectomy (moderate SOE) and Vitamin C (high SOE) were significantly effective in preventing ischemic stroke, and Salt substitute (high SOE) showed significantly reduced hemorrhagic stroke and fatal hemorrhagic stroke risks. Vitamin B6 + B12 + folic acid may lower hemorrhagic stroke and transient ischemic attack risks (moderate SOE). Conclusion: Future studies should prioritize high-quality RCTs with large sample sizes, different follow-up durations and specific stroke types to confirm the efficacy of these non-pharmacological interventions.<\/jats:p>","DOI":"10.1159\/000550330","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T17:00:49Z","timestamp":1769792449000},"page":"1-9","source":"Crossref","is-referenced-by-count":2,"title":["Comparative Effects of Non-Pharmacological Interventions for Stroke Prevention in Adults: A Network Meta-Analysis"],"prefix":"10.1159","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0660-2121","authenticated-orcid":false,"given":"Nhuan Quang","family":"Nguyen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7167-2926","authenticated-orcid":false,"given":"Kim-Ngan 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