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Blood pressure lowering treatment for preventing stroke recurrence: a systematic review and meta-analysis

Shaheen E Lakhan1, Michael T Sapko

  • 1Global Neuroscience Initiative Foundation, Los Angeles, California, USA. slakhan@gnif.org

International Archives of Medicine
|October 22, 2009
PubMed

Insights

Blood pressure lowering drugs significantly reduce recurrent stroke and cardiovascular events in patients with a history of stroke or TIA. These treatments did not impact myocardial infarction or mortality rates.

Area of Science:

  • Cardiology
  • Neurology
  • Pharmacology

Background:

  • Hypertension is a primary stroke risk factor.
  • The efficacy of antihypertensive drugs in preventing secondary strokes is debated.
  • Recent trials show conflicting results on blood pressure lowering for stroke prevention.

Purpose of the Study:

  • To systematically evaluate randomized trials on antihypertensive agents for secondary stroke prevention.
  • To meta-analyze the effects of blood pressure lowering drugs on recurrent stroke and cardiovascular events.

Main Methods:

  • Systematic literature search of MEDLINE, CENTRAL, and ClinicalTrials.gov.
  • Inclusion of randomized, placebo-controlled trials in patients with prior stroke or TIA.
  • Meta-analysis of data from ten relevant studies.

Main Results:

  • Blood pressure lowering agents reduced recurrent stroke by 29% (OR 0.71).
  • Cardiovascular events were also significantly reduced (OR 0.69).
  • No significant effect on myocardial infarction or all-cause mortality was observed.

Conclusions:

  • Antihypertensive medications are effective in preventing recurrent stroke and cardiovascular events post-stroke or TIA.
  • These benefits are achieved without increasing myocardial infarction or mortality.
  • Findings support the use of blood pressure lowering agents for secondary stroke prevention.
Abstract

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