Heterogeneity was present for several outcomes and was partly related to the class of antihypertensive drugs used ; angiotensin-converting enzyme inhibitors and diuretics separately , and especially together , reduced vascular events , while beta-receptor antagonists had no discernable effect .
Evidence from r and omized controlled trials supports the use of antihypertensive agents in lowering blood pressure for the prevention of vascular events in patients with previous stroke or transient ischemic attack .
Vascular prevention is associated positively with the magnitude by which blood pressure is reduced
BACKGROUND High blood pressure is a risk factor for stroke recurrence .
We assessed the effectiveness of lowering blood pressure in preventing recurrent vascular events in patients with previous stroke or transient ischemic attack .
Blood pressure and risk of stroke in patients with cerebrovascular disease
There is widespread clinical uncertainty about lowering blood pressure in patients with ischaemic cerebrovascular disease . This often manifests as comparatively high thresholds for starting treatment and modest targets in reducing blood pressure . Concern has arisen partly from reports of a J shaped association between blood pressure and recurrent stroke in these patients .1 This relation may , however , be because severe strokes are associated both with a fall in blood pressure2 and independently with a relatively high risk of stroke recurrence , rather than from any adverse effects of low blood pressure itself . If this were true , then people with a history of minor cerebrovascular disease would have direct and continuous relations between usual blood pressure and risk of stroke , as observed in people without cerebrovascular disease.3 Data from
Heterogeneity was present for several outcomes and was partly related to the class of antihypertensive drugs used ; angiotensin-converting enzyme inhibitors and diuretics separately , and especially together , reduced vascular events , while beta-receptor antagonists had no discernable effect .
Evidence from r and omized controlled trials supports the use of antihypertensive agents in lowering blood pressure for the prevention of vascular events in patients with previous stroke or transient ischemic attack .
Vascular prevention is associated positively with the magnitude by which blood pressure is reduced
BACKGROUND High blood pressure is a risk factor for stroke recurrence .
We assessed the effectiveness of lowering blood pressure in preventing recurrent vascular events in patients with previous stroke or transient ischemic attack .