High BP is common in patients with FMD, from either essential hypertension or renovascular hypertension related to FMD.752 The optimal BP target for patients with FMD is unknown. In the US FMD registry, most patients were on Smoking cessa- tion should be encouraged for all patients with FMD who smoke because of its health benefits in the general population. The recommenda- tion of using antiplatelet therapy for secondary stroke prevention is based on current practice and expert opinion.752,753,755 In the US FMD regis- try, 73% of patients were prescribed antiplatelet therapy; aspirin was the most common agent.753 There are no placebo-controlled randomized tri- als of patients with symptomatic or asymptomatic FMD comparing aspirin with placebo. Statins are not routinely prescribed for isolated FMD in the absence of another indication. 2. Dissection is a common manifestation associated with FMD, present in 11% to 15% of patients with spontaneous carotid or vertebral artery dis- In the US FMD registry, ischemic stroke was present in 19% of patients presenting with cervical artery dissections.759 The CADISS study demonstrated equivalent efficacy for recur- rent stroke risk in patients with spontaneous, symptomatic cervical carotid dissection random- ized to antiplatelet versus anticoagulant for 3 5.7, Dissection). 3. This recommendation has been adapted from a prior guideline by Brott et al25 on carotid angio- plasty with or without stenting in symptomatic patients with patients to COR 2b. There are no comparative data evaluating medical manage- ment versus angioplasty or stenting for patients with FMD and recurrent ischemic stroke. A case series of 7 patients with symptomatic FMD revealed no complications with balloon Knowledge Gaps and Future Research The optimal medical or interventional management of symptomatic FMD is unknown. 