Rationale: Stroke is a major cause of death and disability in India, often occurring in individuals with low to borderline cardiovascular disease (CVD) risk groups missed by current high-risk-focused strategies. Despite growing global evidence on digital lifestyle tools like the Stroke Riskometer, there is limited implementation evidence on their feasibility and effectiveness across all CVD risk levels in diverse Indian settings.

Novelty: This will be the first large-scale, community-based implementation study in India evaluating a validated digital tool (Stroke Riskometer) for primary stroke prevention in adults at any level of increased CVD risk. The approach integrates personalised risk assessment and lifestyle guidance into a scalable, digital-first model embedded within the public health system.

Objectives: To assess the effectiveness of a Stroke Riskometer-based digital lifestyle intervention in reducing systolic blood pressure and improving behavioural and physiological stroke risk indicators among 15,000 adults aged 40-75 years out of 50,000 screened across five Indian states.

Methods: A cluster-randomised, community-level implementation trial will be conducted across 20 clusters (4 per state), allocated in a 3:1 ratio to intervention and control. Health workers will deliver digital risk profiling, lifestyle counselling, and follow-up support. Outcomes will be evaluated at 12 months using LS7/LE8 scores, clinical data, and behavioural indicators.

Expected Outcome: The trial will generate critical evidence on the feasibility, scalability, and effectiveness of a digital lifestyle intervention within India’s public health system, with anticipated benefits extending to stroke and other major non-communicable diseases.