Clinical Evidence of Blood Pressure Lowering Therapy on the Secondary Prevention of Stroke_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Wen , DENG Qing , HE Hua , Ma Liyuan

Cardiovascular Institute and Fu Wai Hospital; Chinese Academy of Medical Sciences; Beijing 100037; China;

Corresponding author：

Keywords：

Blood pressure lowering therapy; Stroke; Secondary prevention; Clinical evidence

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Objective 　To review randomized controlled trials of blood pressure (BP) lowering therapy on stroke prevention to provide evidence for clinical practice.
Methods 　We searched Medline (1966-2003.6) and the large-sample randomized controlled trials on BP lowering regimen in patients with stroke history were reviewed. Endpoints included the ocurrance of stroke, coronary heart disease and mortality.
Results 　Three trials of PATS, PROGRESS and HOPE were analysed. The review showed that stroke recurrent risk was reduced by 28%, CHD risk decreased by 15% and total mortality risk reduced by 11% in BP lowering treatment group compared with placebo control group. Stroke risk was reduced not only in hypertensive patients with previous cerebrovascular diseases but also in non-hypertensive patients.
Conclusions 　BP lowering therapy is beneficial for the secondary prevention of stroke.

Citation： WANG Wen,DENG Qing,HE Hua,Ma Liyuan. Clinical Evidence of Blood Pressure Lowering Therapy on the Secondary Prevention of Stroke. Chinese Journal of Evidence-Based Medicine, 2004, 04(5): 355-358. doi: Copy

1.	［1］Wang W, Lin LS. Relationship between blood pressure level and stroke recurrence[J]. Chin J Hypertens, 2003; 11:106 -108.
2.	［2］PATS Collaborating Group. Post-stroke antihypertensive treatment study (PATS) , a preliminary result [ J ]. Chin Med J (Engl), 1995; 108(9) :710 -717.
3.	［3］PROGRESS Collaborative Group. Randomised trial of a perindopril-based blood pressure-lowering regimen among 6 105 individuals with previous stroke or transient ischemic attack[J]. Lancet, 2001; 358(9 287):1 033-1 041.
4.	［4］Yusuf S, Sleight P, Pogue J, Bosch J, Davies R, Dagenais G.Effects of an angiotensin-eonverting-enzyme inhibitor, ramipril,on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators[ J]. N Engl J Med, 2000; 342(3):145-153.
5.	［5］Dutch TIA Trial Group. Trial of secondary prevention with atenolol after transient ischemic attack or nondisabling ischemic stroke[J]. Stroke, 1993; 24(4) :543 -548.
6.	［6］Rodgers A, Neal B, MacMahon S. The effects of blood pressure lowering in cerebrovascular disease [ J ]. Neurol Rev Int,1997; 2:12-15.
7.	［7］Hypertension Stroke Cooperative Study Group. Effect of antihypertensive treatment on stroke recurrence[J]. J Am Med Assoc, 1974; 229:409 - 418.

1. ［1］Wang W, Lin LS. Relationship between blood pressure level and stroke recurrence[J]. Chin J Hypertens, 2003; 11:106 -108.
2. ［2］PATS Collaborating Group. Post-stroke antihypertensive treatment study (PATS) , a preliminary result [ J ]. Chin Med J (Engl), 1995; 108(9) :710 -717.
3. ［3］PROGRESS Collaborative Group. Randomised trial of a perindopril-based blood pressure-lowering regimen among 6 105 individuals with previous stroke or transient ischemic attack[J]. Lancet, 2001; 358(9 287):1 033-1 041.
4. ［4］Yusuf S, Sleight P, Pogue J, Bosch J, Davies R, Dagenais G.Effects of an angiotensin-eonverting-enzyme inhibitor, ramipril,on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators[ J]. N Engl J Med, 2000; 342(3):145-153.
5. ［5］Dutch TIA Trial Group. Trial of secondary prevention with atenolol after transient ischemic attack or nondisabling ischemic stroke[J]. Stroke, 1993; 24(4) :543 -548.
6. ［6］Rodgers A, Neal B, MacMahon S. The effects of blood pressure lowering in cerebrovascular disease [ J ]. Neurol Rev Int,1997; 2:12-15.
7. ［7］Hypertension Stroke Cooperative Study Group. Effect of antihypertensive treatment on stroke recurrence[J]. J Am Med Assoc, 1974; 229:409 - 418.

Chinese Journal of Evidence-Based Medicine

Clinical Evidence of Blood Pressure Lowering Therapy on the Secondary Prevention of Stroke

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