Physical activity is associated with a lower risk of first-time stroke. It is unknown if physical exercise reduces risk of recurrent stroke. Clinicians treating stroke patients are inevitably confronted with the question of how to reduce the risk of a second stroke. In addition to the risk of recurrent stroke, a stroke survivor is also at risk of suffering acute myocardial infarction (MI) and other cardiovascular complications. Efforts to reduce cardiovascular risk may potentially also reduce stroke risk.