Hypertension, antihypertensive treatment and stroke prevention

Despite intensive research efforts, few effective treatments are available once stroke has occurred. Thus, stroke prevention should be a primary focus for all health care provides. The purpose of this article is to review the pathophysiological relevance of hypertension as a leading cause of stroke. This will be followed by an analysis of the evidence that blood pressure lowering with different antihypertensive drugs reduces the risk. Finally recent data suggest that the angiotensin II (ATII)-receptor antagonist losartan may offer advantages beyond blood pressure lowering, including attenuation of the central aortic reflected pressure wave, molecule-specific properties and neural protective influences on brain ATII type 2 receptors.