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Renin-Angiotensin system modulators modestly reduce vascular risk in persons with prior stroke

Meng Lee1, Jeffrey L Saver, Keun-Sik Hong

  • 1UCLA Stroke Center and Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.

Stroke
|November 5, 2011
PubMed

Insights

Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers modestly reduce vascular events and recurrent stroke in patients with prior stroke. These medications offer a clear benefit for secondary prevention in this population.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Pharmacology

Background:

  • Efficacy of ACE inhibitors and ARBs is established for coronary heart disease patients.
  • Limited data exists on the benefit of these agents for patients with prior stroke.

Purpose of the Study:

  • To evaluate if ACE inhibitors or ARBs reduce future vascular events in individuals with a history of stroke.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials.
  • Searched PubMed, Cochrane Central Register, and trial bibliographies.
  • Pooled data to calculate relative risk for major vascular events and recurrent stroke.

Main Results:

  • Eight trials with 29,667 participants were analyzed.
  • ACE inhibitors/ARBs significantly lowered risks of major vascular events (RR 0.91) and recurrent stroke (RR 0.93).
  • Number needed to treat was 71 for major vascular events and 143 for recurrent stroke.

Conclusions:

  • ACE inhibitors or ARBs provide a modest but significant reduction in vascular risk for patients with prior stroke.
  • These findings support the use of these agents for secondary vascular prevention.
Abstract

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