Introduction. The competencies of physicians are the clinical and organizational basis for managing the stable course of chronic cardiovascular diseases (CVD) in terms of identifying risk factors and preventing complications, including socially significant ischemic stroke (IS). Purpose of the research: to research the competence-based activity of physicians of various specialties at the primary health care level in terms of identifying risk factors for IS. Material and methods: a retrospective, multicenter, anonymous research was in 2021-2024. Objects: physicians (n = 165) of surgical (n = 79) and therapeutic (n = 86) specialties; patients (n = 2145). The big data of the initial consultation were copied from the electronic medical records of patients. The competence activity of physicians was assessed based on the performance of medical social processes: examination of blood pressure (BP) on one/both shoulders, pulse rate and rhythm, body mass index (BMI), frequency of nocturia and lower limb edema, family and personal history of CVD, patient adherence to drug therapy and participation in consultation of a family member. The author's method of scoring the competence activity of physicians was applied: high degree (7 points) - physicians examine all medical social processes; average (3–7 points) — physicians examine only blood pressure in one shoulder, pulse rate and rhythm, swelling of the lower extremities, family and personal history of cardiovascular disease, low (<3 points) — all other cases. Research methods: content analysis, statistical, comparative analysis, mathematical, expert. Results: in identifying risk factors for IS, a high degree of competence activity was found in 1.8% of physicians — 2.5% of surgical and 1.1% of therapeutic specialties (p = 0.09), an average degree in 41.2% of physicians — 20.3% of surgical and 48.8% of therapeutic specialties (p = 0.025), a low degree in 57.0% of physicians — 77.2% of surgical and 38.4% of therapeutic specialties (p = 0.02). Conclusion: the research established mainly an average and low levels of physicians’competence activity in identifying risk factors for IS, which may explain the persistent negative epidemiological trends in CVD. Continuous medical education and mentoring can contribute to the development of physicians’ competence activity based on induced motivation for professional development. © 2025 Elsevier B.V., All rights reserved.