Stroke: Renin-angiotensin system inhibitors/blockers to reduce recurrent stroke
DISEASE INTERVENTION COMPARISON RESULTS
Stroke. 2003 Jul;34(7):1699-703 Randomized Controlled Trial
IN stroke, hypertension in the early acute phase The Use of
modest blood pressure reduction by angiotensin II receptor blockers, candesartan
As Treatment, Acute
Is better Than
no treatment of hypertension
To reduce cumulative 12-month mortality and reduce vascular events. No cardio-cerebrovascular event occurred as a result of hypotension
Stroke. 2005 Jun;36(6):1218-26. Epub 2005 May 5 Randomized Controlled Trial, Multicenter Study
IN stroke, hypertension, primary The Use of
angiotensin II receptor blockers, eprosartan
As Treatment, Chronic
Is better Than
calcium antagonist, nitrendipine
To reduce a composite of total mortality and all cardiovascular and cerebrovascular events: 283 total events with sartan VS 366 with nitrendipine at 2.5 years.
Lancet. 2001 Sep 29;358(9287):1033-41 Randomized Controlled Trial, Multicenter Study
IN stroke, hypertension, primary, non-hypertensive patients The Use of
angiotensin converting enzyme inhibitors (perindopril, 4 mg/d), plus discretional indapamide
As Prevention, Secondary
Is better Than
placebo
To reduce stroke (either ischemic or haemorrhagis) at 4 years: 10% with perindopril VS 14% with placebo. Also, it reduced major vascular events, but not mortality.
N Engl J Med. 2008 Sep 18;359(12):1225-37 Randomized Controlled Trial, Multicenter Study
IN stroke, ischemic, with or without hypertension The Use of
angiotensin II receptor blockers, telmisartan
As Treatment, Chronic
Is equal Than
placebo
To reduce at 2.5 years recurrent stroke (8.7% telmisartan VS 9.2% placebo) or cardiovascular events (13.5% telmisartan VS 14..4% placebo)