Antihypertensive medications for risk reduction of first and recurrent ischemic stroke.
It is increasingly clear that even a small reduction in blood pressure results in a substantial risk reduction of vascular events including ischemic stroke. Recently, several comparative prospective trials of angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers have demonstrated that, for equivalent reductions in blood pressure, these drugs may confer a greater effect on the prevention of primary and recurrent ischemic stroke compared with other antihypertensive medications. Given this information from prospective randomized trials, it appears that this class of drugs should be the first-line treatment for hypertension in patients at risk of a first or recurrent ischemic stroke. This review will critically assess the scientific basis and rationale of the use of angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers in primary and secondary stroke prevention.
Padma
Vasamtha
V
All India Institute of Medical Sciences, New Delhi, India. vasamtha.padma@hotmail.com
Fisher
Marc
M
Moonis
Majaz
M
D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002545:Brain Ischemia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention / Q000379:methods; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012720:Severity of Illness Index; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D016019:Survival Analysis; D016896:Treatment Outcome
D000959:Antihypertensive Agents