Anti hypertensive therapy in the prevention of stroke: What is stated in the guidelines?

作者：Grond M^*

来源：Diabetes, Stoffwechsel und Herz, 2008, 17(3): 181-188.

• stroke
• hypertension
• primary prevention
• secondary prevention

At 9.5%, stroke is the third leading cause of death in Germany. Hypertension is considered to be the key contributing factor in the incidence of stroke. Therefore, the reduction of hypertension plays an important role in preventing morbidity and mortality. The Joint Guidelines of the German Association of Neurology (DGN) and the German Stroke Association (DSG) strongly focus on the treatment of hypertension for primary and secondary prevention of cerebral ischaemia. For primary prevention, ACE-inhibitors, AT(1)-blockers, beta-blockers, calcium-channel-blockers, and diuretics are considered to be equally effective. In patients with a previous stroke, studies on secondary prevention indicate that anti hypertensive agents should be selected carefully. The Perindopril Protection Against Recurrent Stroke Study (PROGRESS) observed that the ACE-inhibitor perindopril was only able to reduce subsequent cerebrovascular infarctions in combination with the diuretic, indapamide. The MOSES study, which compared the AT(1)-blocker, eprosartan, with the calcium-channel-blocker, nitrendipine, demonstrated that eprosartan displays a cerebro-protective effect, which goes beyond that of its blood-pressure-lowering effect.

• 出版日期2008-5-20