Atherosclerosis is a systemic disease affecting arteries throughout the body. Multiple factors including hypertension, diabetes, hyperlipidemia, and family history influence stroke and TIA risk (Table 17-5). Cardioembolic risk factors include atrial fibrillation/flutter, MI, valvular heart disease, and cardiomyopathy. Hypertension and diabetes are also specific risk factors for lacunar stroke and intraparenchymal hemorrhage. Smoking is a potent risk factor for all vascular mechanisms of stroke. Identification of modifiable risk factors and prophylactic interventions to lower risk is probably the best approach to stroke overall.