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Blood pressure control in primary and secondary prevention of stroke


Authors: Prof. MUDr. Miroslav Souček, CSc.
Authors‘ workplace: II. interní klinika LF MU a FN u sv. Anny v Brně miroslav. soucek@fnusa. cz
Published in: Kardiol Rev Int Med 2013, 15(1): 54-58
Category:

Overview

Primary and secondary preventive measurements significantly decrease the risk of stroke development. Hypertension is one of the most significant risk factors. Moderate drop in values of systolic-diastolic blood pressure leads to 42% decrease in the incidence of stroke. Anti-hypertensive treatment decreases the recurrence probability in patients that already have had a stroke, also in those considered to have normal blood pressure. Evidence for such treatment has been obtained primarily for the combination of ACE inhibitor and diuretic. Unambiguous evidence for optimal treatment in acute phase of a stroke is absent until now. Using angiotensin II receptor blockers in small doses has been shown as secure. Reduced blood pressure may also have a favourable impact on cognitive functions and dementia.

Keywords:
hypertension – stroke – primary and secondary prevention


Sources

1. Kalita Z et al. Akutní cévní mozkové příhody. Praha: Maxdorf 2006.

2. Mancia G, De Backer G, Dominiczak A et al. Management of Arterial Hypertension of the European Society of Hypertension; European Society of Cardiology. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007; 25: 1105–1187.

3. Bosch J, Yusuf S, Pogue J et al. HOPE Investigators. Heart outcomes prevention. Use of ramipril in preventing stroke: double blind randomised trial. Br Med J 2002; 324: 699–702.

4. Progress Collaborative Group. Randomised trial of a perindopril-based blood pressure lowering regiment among 6,105 individuals with previous stroke or tran­sient ischaemic attack. Lancet 2001; 358: 1033–1041.

5. Neal B, MacMahon J, Chapman N. Blood Pressure Lowering Treatment Trialists‘ Collaboration. Effects of ACE inhibitors, calcium antagonists, and other blood pressure lowering drugs: results of prospectively designed overviews of randomised trials. Blood Pressure Lowering Treatment Trialists’ Collaboration. Lancet 2000; 356: 1955–1964.

6. Filipovský J, Widimský J Jr, Ceral J et al. Diagnostické a léčebné postupy u arteriální hypertenze – verze 2012. Doporučení České společnosti pro hypertenzi. Vnitř Lék 2012; 58: 785–801.

7. Simon G. Why do treated hypertensives suffer strokes? An internist’s perspective. J Clin Hypertens 2002; 4: 338–344.

8. Widimský J et al. Hypertenze. 2. přepr. vyd. Praha: Triton 2004.

9. Hansson L, Zanchetti A, Carruthers SG et al. Effects of intensive blood-pressure lowering and low-dose of aspirin in patients with hypertension: principal results of the Hypertension optimal treatment (HOT) randomised trial. HOT Study Group. Lancet 1998; 351: 1755–1762.

10. Ezekowitz JA, Straus SE, Majumdar SR et al. Stroke: Strategies for primary prevention. Am Fam Physician 2003; 68: 2379–2386.

11. Staesen JA, Wang JG, Thijs L. What can be expected from optimal blood pressure control? J Hypertens 2003; 21 (Suppl 2): S3–S9.

12. Dahlöf B, Sever PS, Poulter NR et al. ASCOT investigators. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controled trial. The Lancet 2005; 366: 895–906.

13. Souček M. Diabetes mellitus a cévní onemocnění mozku. Vnitř Lék 2003; 49: 916–920.

14. UK Prospective Diabetes Study Group. Efficacy of atenolol and captopril in reducing risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS. BMJ 1998; 317: 713–721.

15. Malion JM. Blood pressure variations troughout sleep. XIVth European Meeting on Hypertension, Paris, June 13–17, 2004, paper.

16. Staněk V. Prevence mozkových cévních příhod. In: MedEvent-Hypertension Prague 2002, Praha: Praha Publishing s.r.o. 2002: 56–60.

17. Beckett NS, Peters R, Fletcher AE et al. HYVET Study Group. Treatment of hypertension in patients 80 years of age or older. N Engl J Med 2008; 358: 1887–1898.

18. ADVANCE Collaborative Group. Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial. Lancet 2007; 370: 829–840.

19. ACCORD Study Group, Cushman WC, Evans GW, Byington RP et al. Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med 2010; 362: 1575–1585.

20. Widimský J. Jaké jsou optimální hodnoty systolického tlaku u diabetiků? Studie ACCORD Blood Pressure dokončena. Cor Vasa 2010; 52: 700–705.

21. Mancia G, Laurent S, Agabiti-Rosei E et al. European Society of Hypertension. Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. J Hypertens 2009; 27: 2121–2158.

22. PATS Collaborative Group. Post-stroke antihypertensive treatment study. Chin Med J 1995; 108: 710–717.

23. Arima H, Chalmers J, Woodward M et al. PROGRESS Collaborative Group. Lower target blood pressures are safe and effective for the prevention of recurrent stroke: the PROGRESS trial. J Hypertens 2006; 24: 1201–1208.

24. Trenkwalder P, Elmfeldt D, Hofman A et al. Study on Cognition and Prognosis in the Elderly (SCOPE). The study on cognition and prognosis in the elderly (SCOPE) – major cardiovascular events and stroke in subgroups of patients. Blood Press 2005; 14: 31–37.

25. Schrader J, Lüders S, Kulschewski A et al. MOSES Study Group. Morbidity and mortality after Stroke. Eprosartan compared with nitrendipine for secondary prevention: principal results of a prospective randomized controlled study (MOSES). Stroke 2005; 36: 1218–1226.

26. Yusuf S, Diener HC, Sacco RL et al. PRoFESS Study Group. Telmisartan to prevent recurrent stroke and cardiovascular events. N Engl J Med 2008; 359: 1225–1237.

27. Schrader J, Lüders S, Kulschewski A et al. Acute Candesartan Cilexetil Therapy in Stroke Survivors. The ACCESS Study: Evaluation of Acute Candesartan Cilexetil Therapy in Stroke Surviovors. Stroke 2003; 34: 1699–1703.

28. Skoog I, Lernfelt B, Landahl S et al. 15-years longitudinal study of blood pressure and dementia. Lancet 1996; 347: 1141–1145.

29. Launer LJ, Masaki K, Petrovitch H et al. The association between midlife blood pressure levels and late-life cognitive function. The Honolulu-Asia Aging Study. JAMA 1995; 274: 1846–1851.

30. Birns J, Morris R, Donaldson N et al. The effects of blood pressure reduction on cognitive function: a review of effects based on pooled data from clinical trial. J Hypertens 2006; 24: 1907–1914.

32. Hénon H, Pasquier F, Durieu I et al. Preexisting dementia in stroke patients. Baseline frequency, associated factors, and outcome. Stroke 1997; 28: 785–792.

33. Vermeer SE, Prins ND, den Heijer T et al. Silent brain infarcts and the risk of dementia and cognitive decline. N Engl J Med 2003; 348: 1215–1222.

Labels
Paediatric cardiology Internal medicine Cardiac surgery Cardiology
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