Lowering of Blood Pressure for Recurrent Stroke Prevention

STROKEAHA: July 1, 2014

Hypertension is the premier modifiable risk factor for stroke.^1,2 Indeed, ≤50% of strokes may be attributable to hypertension, and the relationship of hypertension with stroke also comprises distinct independent links between both systolic and diastolic hypertension and the occurrence of both primary and recurrent strokes.³ Furthermore, the underlying pathophysiological rationale and clinical trial evidence for lowering blood pressure (BP) in people with hypertension to safely prevent a primary stroke of any type are overwhelmingly clear.⁴ However, when it comes to recurrent stroke prevention, questions surrounding BP treatment linger, including what exactly to do, when precisely to do it, and whether the approach should vary by type of patient. This comparative lack of clarity about the nature of the BP-lowering strategy after a stroke has arisen because of theoretical efficacy/safety concerns related to the acuity and type of index stroke, as well as the paucity of published hypertension treatment trials for recurrent stroke prevention. Read More