BACKGROUND: Secondary prevention of stroke has been shown to dramatically reduce recurrence and has been described as suboptimal. OBJECTIVE: To analyse patients' awareness and knowledge about cerebrovascular risk factors (CVRF) and their influence on CVRF control. METHODS: Patients (n = 164) who were attending a stroke outpatient clinic for the first time after hospital discharge (3 months) for a first stroke were asked to answer a short questionnaire including questions on awareness and knowledge of CVRF, visits to a CVRF specialist, number of visits to a general practitioner, adherence to drug treatments, cigarette smoking and cessation. RESULTS: CVRF were spontaneously mentioned as relevant for their stroke by only 13% of patients. A specialist was visited by only one-third of the patients and a general practitioner was not visited at all by 27% of the patients since their stroke. Awareness was inversely correlated with older age and good recovery. More than half of the patients had high blood pressure (> or = 140 mmHg for systolic and > or = 90 mmHg for diastolic values) at the time of follow-up. These high values were correlated with poor awareness. Appropriate secondary stroke prevention measures were not received by one-fourth of the patients; this was also correlated with poor awareness. CONCLUSIONS: CVRF control is not optimal and is at least partially related to patients' awareness and knowledge and suboptimal medical follow-up. Older patients and patients with excellent recovery are at particular risk for poor awareness and CVRF control.