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Prospects for the prevention of stroke.
J Hypertens Suppl. 2006 Apr; 24(2):S3-9.JH

Abstract

We are currently fighting a battle against a stroke epidemic. Implementation of new treatment strategies could save many patients in the future. The control of blood pressure is a major objective; however, choosing specific antihypertensive therapy (e.g. an agent blocking the renin-angiotensin system) is also important. The Losartan Intervention For Endpoint reduction in hypertension (LIFE) study demonstrates potential benefits beyond blood pressure reduction of prescribing an angiotensin II receptor blocker (ARB) compared with more established therapy in patients with left ventricular hypertrophy (LVH). Losartan-based therapy brought about regression of LVH and reduced incidences of fatal and non-fatal stroke by 25%, new-onset diabetes by 25% and atrial fibrillation by 30% more than atenolol-based therapy for a similar blood pressure control and better tolerability. The Study on COgnition and Prognosis in the Elderly (SCOPE) study, although difficult to interpret, does not contradict an ARB benefit beyond blood pressure lowering in primary prevention linked to targeting the angiotensin type 1 receptor. The findings of the MOrbidity and mortality after Stroke, Eprosartan compared with nitrendipine in Secondary prevention (MOSES) trial suggest clear-cut ARB benefits independent of blood pressure lowering in secondary stroke prevention. Experimental findings and other clinical evidence further support the benefits of ARBs in stroke prevention. Telmisartan is an ARB with a particularly interesting profile for stroke; given the 24-hour efficacy with more pronounced protection against the morning blood pressure surge and peroxisome proliferator-activated receptor-gamma activity at clinical doses. The unique properties of telmisartan for secondary stroke prevention are being tested in the Prevention Regimen For Effectively avoiding Second Strokes (PRoFESS) study.

Authors+Show Affiliations

Sahlgrenska University Hospital/Ostra, Göteborg, Sweden. bdahlof@scri.se

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16601558

Citation

Dahlöf, Björn. "Prospects for the Prevention of Stroke." Journal of Hypertension. Supplement : Official Journal of the International Society of Hypertension, vol. 24, no. 2, 2006, pp. S3-9.
Dahlöf B. Prospects for the prevention of stroke. J Hypertens Suppl. 2006;24(2):S3-9.
Dahlöf, B. (2006). Prospects for the prevention of stroke. Journal of Hypertension. Supplement : Official Journal of the International Society of Hypertension, 24(2), S3-9.
Dahlöf B. Prospects for the Prevention of Stroke. J Hypertens Suppl. 2006;24(2):S3-9. PubMed PMID: 16601558.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospects for the prevention of stroke. A1 - Dahlöf,Björn, PY - 2006/4/8/pubmed PY - 2006/7/19/medline PY - 2006/4/8/entrez SP - S3 EP - 9 JF - Journal of hypertension. Supplement : official journal of the International Society of Hypertension JO - J Hypertens Suppl VL - 24 IS - 2 N2 - We are currently fighting a battle against a stroke epidemic. Implementation of new treatment strategies could save many patients in the future. The control of blood pressure is a major objective; however, choosing specific antihypertensive therapy (e.g. an agent blocking the renin-angiotensin system) is also important. The Losartan Intervention For Endpoint reduction in hypertension (LIFE) study demonstrates potential benefits beyond blood pressure reduction of prescribing an angiotensin II receptor blocker (ARB) compared with more established therapy in patients with left ventricular hypertrophy (LVH). Losartan-based therapy brought about regression of LVH and reduced incidences of fatal and non-fatal stroke by 25%, new-onset diabetes by 25% and atrial fibrillation by 30% more than atenolol-based therapy for a similar blood pressure control and better tolerability. The Study on COgnition and Prognosis in the Elderly (SCOPE) study, although difficult to interpret, does not contradict an ARB benefit beyond blood pressure lowering in primary prevention linked to targeting the angiotensin type 1 receptor. The findings of the MOrbidity and mortality after Stroke, Eprosartan compared with nitrendipine in Secondary prevention (MOSES) trial suggest clear-cut ARB benefits independent of blood pressure lowering in secondary stroke prevention. Experimental findings and other clinical evidence further support the benefits of ARBs in stroke prevention. Telmisartan is an ARB with a particularly interesting profile for stroke; given the 24-hour efficacy with more pronounced protection against the morning blood pressure surge and peroxisome proliferator-activated receptor-gamma activity at clinical doses. The unique properties of telmisartan for secondary stroke prevention are being tested in the Prevention Regimen For Effectively avoiding Second Strokes (PRoFESS) study. SN - 0952-1178 UR - https://www.unboundmedicine.com/medline/citation/16601558/Prospects_for_the_prevention_of_stroke_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=16601558.ui DB - PRIME DP - Unbound Medicine ER -