Dr. David Spence, a clinician-scientist trained in Neurology, Internal Medicine and Clinical Pharmacology, has devoted his entire career to prevention of stroke. His clinical work has prevented an estimated 5,000 strokes, but his research, teaching and publications, by changing the way physicians approach stroke prevention, have prevented many more. He led many clinical trials of stroke prevention, including 4 major trials funded by NIH. He pioneered the understanding of pseudohypertension, co-discovered the effect of grapefruit on drug metabolism, pioneered the measurement of carotid atherosclerotic plaque, and has shown its usefulness in patient management, genetic research and evaluation of new therapies.