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Role of antihypertensive therapy with angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers in combination with calcium channel blockers for stroke prevention.
J Am Pharm Assoc (2003). 2010 Sep-Oct; 50(5):e116-25.JA

Abstract

OBJECTIVE

To review the available literature on the effects of angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), and calcium channel blockers (CCBs) or combinations of these agents on stroke outcomes in hypertensive patients.

DATA SOURCES

A Medline search was conducted using the search terms stroke and antihypertensives, calcium channel blockers, angiotensin-converting enzyme inhibitors, or angiotensin II receptor blockers from 1985 to August 17, 2009.

STUDY SELECTION

Randomized controlled clinical trials with at least 400 randomized patients were selected if at least one of the treatment arms used a CCB, ACEI, or ARB to evaluate stroke outcomes in hypertensive patients.

DATA SYNTHESIS

The prevalence of stroke is high in the United States, accounting for approximately 150,000 deaths per year. Early identification and treatment of hypertension to quickly achieve blood pressure reduction is critical in the prevention of stroke. Many trials have provided evidence that CCBs, ACEIs, and ARBs are effective in stroke prevention. Most patients require two or more antihypertensive drugs to achieve blood pressure goals. Because of their complementary actions, combination antihypertensive therapy with a renin-angiotensin-aldosterone system (RAAS) blocker and a CCB may help reduce stroke incidence to a greater extent than either of the monotherapies.

CONCLUSION

A growing body of clinical trial data suggest that aggressive combination antihypertensive therapy, including a RAAS blocker and CCB, may help reduce stroke incidence. Fixed-dose combination therapy is an important consideration in optimizing blood pressure control and patient adherence to therapy in stroke prevention.

Authors+Show Affiliations

College of Pharmacy, University of Texas at Austin, USA. talbert@uthscsa.edu

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

20833609

Citation

Talbert, Robert L.. "Role of Antihypertensive Therapy With Angiotensin-converting Enzyme Inhibitors or Angiotensin II Receptor Blockers in Combination With Calcium Channel Blockers for Stroke Prevention." Journal of the American Pharmacists Association : JAPhA, vol. 50, no. 5, 2010, pp. e116-25.
Talbert RL. Role of antihypertensive therapy with angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers in combination with calcium channel blockers for stroke prevention. J Am Pharm Assoc (2003). 2010;50(5):e116-25.
Talbert, R. L. (2010). Role of antihypertensive therapy with angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers in combination with calcium channel blockers for stroke prevention. Journal of the American Pharmacists Association : JAPhA, 50(5), e116-25. https://doi.org/10.1331/JAPhA.2010.09234
Talbert RL. Role of Antihypertensive Therapy With Angiotensin-converting Enzyme Inhibitors or Angiotensin II Receptor Blockers in Combination With Calcium Channel Blockers for Stroke Prevention. J Am Pharm Assoc (2003). 2010 Sep-Oct;50(5):e116-25. PubMed PMID: 20833609.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of antihypertensive therapy with angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers in combination with calcium channel blockers for stroke prevention. A1 - Talbert,Robert L, PY - 2010/9/14/entrez PY - 2010/9/14/pubmed PY - 2011/3/23/medline SP - e116 EP - 25 JF - Journal of the American Pharmacists Association : JAPhA JO - J Am Pharm Assoc (2003) VL - 50 IS - 5 N2 - OBJECTIVE: To review the available literature on the effects of angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), and calcium channel blockers (CCBs) or combinations of these agents on stroke outcomes in hypertensive patients. DATA SOURCES: A Medline search was conducted using the search terms stroke and antihypertensives, calcium channel blockers, angiotensin-converting enzyme inhibitors, or angiotensin II receptor blockers from 1985 to August 17, 2009. STUDY SELECTION: Randomized controlled clinical trials with at least 400 randomized patients were selected if at least one of the treatment arms used a CCB, ACEI, or ARB to evaluate stroke outcomes in hypertensive patients. DATA SYNTHESIS: The prevalence of stroke is high in the United States, accounting for approximately 150,000 deaths per year. Early identification and treatment of hypertension to quickly achieve blood pressure reduction is critical in the prevention of stroke. Many trials have provided evidence that CCBs, ACEIs, and ARBs are effective in stroke prevention. Most patients require two or more antihypertensive drugs to achieve blood pressure goals. Because of their complementary actions, combination antihypertensive therapy with a renin-angiotensin-aldosterone system (RAAS) blocker and a CCB may help reduce stroke incidence to a greater extent than either of the monotherapies. CONCLUSION: A growing body of clinical trial data suggest that aggressive combination antihypertensive therapy, including a RAAS blocker and CCB, may help reduce stroke incidence. Fixed-dose combination therapy is an important consideration in optimizing blood pressure control and patient adherence to therapy in stroke prevention. SN - 1544-3450 UR - https://www.unboundmedicine.com/medline/citation/20833609/Role_of_antihypertensive_therapy_with_angiotensin_converting_enzyme_inhibitors_or_angiotensin_II_receptor_blockers_in_combination_with_calcium_channel_blockers_for_stroke_prevention_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1544-3191(15)30885-2 DB - PRIME DP - Unbound Medicine ER -