Secondary prevention of stroke by blood pressure-lowering treatment

Hisatomi Arima, John Chalmers

    Research output: Contribution to journalReview articlepeer-review

    2 Citations (Scopus)


    High blood pressure is the most important modifiable risk factor for stroke, accounting for more than 50% of the population-attributable fraction for stroke. There is now strong evidence from randomized trials that blood pressure-lowering treatment is one of the most effective and generalizable strategies for secondary prevention of stroke. Once the patient with stroke has stabilized, all patients should receive blood pressure-lowering therapy, irrespective of their blood pressure levels. Combination therapy with an angiotensin-converting enzyme (ACE) inhibitor plus a diuretic is an established regimen, but an angiotensin II-receptor blocker may provide an alternative regimen in patients who do not tolerate an ACE inhibitor, especially in combination with a diuretic. For patients with previous stroke, goal blood pressures of < 130/80 mm Hg in hypertensive subjects and < 120/80 mm Hg in normotensive (or "prehypertensive") subjects should be achieved using combination blood pressure-lowering therapy.

    Original languageEnglish
    Pages (from-to)317-323
    Number of pages7
    Issue number4
    Publication statusPublished - Aug 2006


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