Antihypertensive Drug Therapies and the Risk of Ischemic Stroke

Open Access
Publisher Website
Google Scholar
Abstract
THE PRIMARY purpose of the pharmacological treatment of hypertension is to prevent major cardiovascular complications such as stroke. The 4 most widely used antihypertensive drug classes include diuretics, β-blockers, calcium channel blockers, and angiotensin-converting enzyme (ACE) inhibitors. Randomized clinical trials (RCTs) have not demonstrated major differences between these antihypertensive drug classes with regard to lowering of blood pressure,1-4 quality of life,3,5 or regression of left ventricular mass.6-8 Results of recent meta-analyses of antihypertensive drug treatment compared with placebo suggest that low-dose diuretic therapy is effective in reducing the risk of stroke, coronary heart disease, congestive heart failure, and total mortality, whereas β-blockers prevent stroke and congestive heart failure but seem less effective in preventing coronary heart disease,9 especially in the elderly.10 The Systolic Hypertension in Europe Trial has demonstrated that compared with placebo, the calcium channel blocker nitrendipine reduces the incidence of stroke in older adults with isolated systolic hypertension.11