CONCLUSION Despite recent large trials showing no significant effect , in patients that have experienced a TIA or stroke , blood pressure lowering agents reduced the occurrence of subsequent stroke and cardiovascular events .
The rate of myocardial infa rct ion and all-cause mortality was unchanged
BACKGROUND While hypertension is a leading risk factor for an initial stroke , the role of blood pressure lowering to prevent subsequent stroke is less clear .
The results of recent large clinical trials investigating effects of antihypertensive agents in patients with a history of stroke have not shown a significant benefit ; findings that are at odds with previous data .
Our meta- analysis systematic ally evaluates the available , relevant trials to examine the role of antihypertensive drugs in preventing recurrent stroke .
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
CONCLUSION Despite recent large trials showing no significant effect , in patients that have experienced a TIA or stroke , blood pressure lowering agents reduced the occurrence of subsequent stroke and cardiovascular events .
The rate of myocardial infa rct ion and all-cause mortality was unchanged
BACKGROUND While hypertension is a leading risk factor for an initial stroke , the role of blood pressure lowering to prevent subsequent stroke is less clear .
The results of recent large clinical trials investigating effects of antihypertensive agents in patients with a history of stroke have not shown a significant benefit ; findings that are at odds with previous data .
Our meta- analysis systematic ally evaluates the available , relevant trials to examine the role of antihypertensive drugs in preventing recurrent stroke .