Related Experiment Video

Updated: Jun 3, 2025

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

12.0K

Antihypertensive strategies for the prevention of secondary stroke: a systematic review and meta-analysis

ChunQi Wang1,2, Ling Feng3,4, ShuangYan Tu5,6

  • 1Department of Neurology, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Wuhou District, Chengdu, 610041, Sichuan, China. 1148882393@qq.com.

European Journal of Medical Research
|January 9, 2025
PubMed

Insights

Antihypertensive therapy significantly reduces the risk of recurrent stroke, cardiovascular deaths, and myocardial infarctions. Intensive blood pressure control (IBPC) offers superior protection against stroke recurrence and mortality compared to standard blood pressure control (SBPC).

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Clinical Trials

Background:

  • Stroke is a leading global cause of death and disability.
  • Hypertension is a primary risk factor for recurrent stroke.
  • Elevated blood pressure at admission is linked to increased stroke recurrence risk.

Purpose of the Study:

  • To evaluate the efficacy of antihypertensive therapy in preventing recurrent stroke.
  • To compare intensive blood pressure control (IBPC) with standard blood pressure control (SBPC) for stroke recurrence prevention.
  • To assess the impact of blood pressure management on cardiovascular outcomes and mortality in stroke patients.

Main Methods:

  • Systematic search of major databases (PubMed, Embase, Cochrane, Web of Science) for randomized controlled trials (RCTs) up to January 12, 2024.
  • Included RCTs compared antihypertensive drugs vs. placebo/no treatment or IBPC vs. SBPC.
  • Analyzed primary outcomes including stroke recurrence, fatal/non-fatal strokes, cardiovascular deaths, and myocardial infarctions (MIs).

Main Results:

  • Antihypertensive therapy reduced recurrent stroke risk (RR=0.86), cardiovascular deaths (RR=0.92), and MIs (RR=0.87) compared to placebo.
  • IBPC significantly lowered recurrent stroke risk (RR=0.87), cardiovascular deaths (RR=0.75), and all-cause mortality (RR=0.85) compared to SBPC.
  • Analysis included 19 RCTs with 72,048 patients.

Conclusions:

  • Antihypertensive therapy is effective in preventing recurrent stroke, cardiovascular deaths, and MIs in stroke survivors.
  • IBPC offers superior protection against stroke recurrence, cardiovascular mortality, and all-cause mortality compared to SBPC.
  • Blood pressure management is crucial for secondary stroke prevention.
Abstract

Keywords:
Antihypertensive therapyBlood pressure managementHypertensionMeta-analysisRecurrent strokeSecondary preventionStroke

More Related Videos

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

83.5K
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia06:01

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia

Published on: August 18, 2015

14.8K

Related Concept Videos

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
381
Antihypertensive Drugs: Direct Renin Inhibitors01:25

Antihypertensive Drugs: Direct Renin Inhibitors

The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
484
Antihypertensive Drugs: Vasodilators01:23

Antihypertensive Drugs: Vasodilators

Vasodilators, primarily affecting the smooth muscles within arterial and venous walls, are commonly used for hypertension treatment. Medications such as minoxidil and hydralazine primarily target arteries and arterioles, while sodium nitroprusside acts on arterioles and venules. Minoxidil, functioning as a prodrug, is metabolized by hepatic sulfotransferase into its active form, minoxidil sulfate, after oral administration. This metabolite binds to the sulfonylurea receptor (SUR) component of...
473
Antihypertensive Drugs: Action of Diuretics01:16

Antihypertensive Drugs: Action of Diuretics

Diuretics are antihypertensive drugs used to treat hypertension resulting from sodium and water retention. Sodium, vital for fluid balance and nerve or muscle function, is regulated by the kidneys through millions of nephrons. Blood enters nephrons via afferent arterioles, which branch into capillaries called glomeruli. These filter blood plasma, allowing water and solutes, like sodium ions, to pass through capillary walls into Bowman's capsule. The filtrate then flows through various...
617
Hypertension and Regulation of Blood Pressure01:18

Hypertension and Regulation of Blood Pressure

Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
1.9K
Antihypertensive Drugs: Angiotensin II Receptor Blockers01:30

Antihypertensive Drugs: Angiotensin II Receptor Blockers

In the renin-angiotensin-aldosterone system, a hormone called angiotensin II plays a crucial role. It binds to the AT1 receptors in vascular smooth muscles coupled with Gq proteins. The activation of these receptors activates an enzyme called phospholipase C, which releases two molecules: inositol trisphosphate and diacylglycerol. These molecules cause a chain reaction that leads to the phosphorylation of myosin light chains and promotes interaction between actin and myosin, leading to smooth...
579