In conclusion, although researches exploring this interesting paradox have been emerged in multiple disease categories, the exact patho-mechanisms were not still identified yet. While the “paradox in stroke” seems to be a fascinating hypothesis, it might be a mere epiphenomenon or a transitional process toward disastrous clinical outcomes. Therefore, in considering unconfirmed limitations, physicians should carefully apply this hypothesis until more research is accumulated.

It is strongly recommended that active or passive smoking should be avoided in stroke patients. Regarding alcohol drinking, drinking greater than two drinks per day should be avoided. In terms of obesity, beneficial impact of weight reduction in obese stroke patients has not been explored, but weight reduction is still being recommended in body mass index ≥ 25 mg/m².