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Secondary prevention of stroke by blood pressure-lowering treatment

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Abstract

High blood pressure is the most important modiflable risk factor for stroke, accounting for more than 50% of the population-attributable fraction for stroke. There is now strong evidence from randomized trials that blood pressure-lowering treatment is one of the most effective and generalizable strategies for secondary prevention of stroke. Once the patient with stroke has stabilized, all patients should receive blood pressure-lowering therapy, irrespective of their blood pressure levels. Combination therapy with an angiotensin-converting enzyme (ACE) inhibitor plus a diuretic is an established regimen, but an angiotensin II-receptor blocker may provide an alternative regimen in patients who do not tolerate an ACE inhibitor, especially in combination with a diuretic. For patients with previous stroke, goal blood pressures of < 130/80 mm Hg in hypertensive subjects and < 120/80 mm Hg in normotensive (or “prehypertensive”) subjects should be achieved using combination blood pressure-lowering therapy.

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Authors and Affiliations

  1. The George Institute for International Health, University of Sydney, Missenden Road, PO Box M201, 2050, NSW, Australia

    John Chalmers MD

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  1. Hisatomi Arima MD
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  2. John Chalmers MD
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Correspondence to John Chalmers MD.

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Arima, H., Chalmers, J. Secondary prevention of stroke by blood pressure-lowering treatment. Current Science Inc 8, 317–323 (2006). https://doi.org/10.1007/s11906-006-0071-2

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  • DOI: https://doi.org/10.1007/s11906-006-0071-2

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