Hypertension and stroke: an appraisal of the evidence and implications for clinical management

Expert Review of Cardiovascular Therapy
Daniel T LacklandAndrea D Boan

Abstract

While elevated blood pressure has long been associated with cardiovascular and renal outcomes, the association of hypertension and increased stroke risks is perhaps the strongest and best recognized. Furthermore, the reduction of blood pressure with antihypertensive agents has been well documented with lower stroke risks. The specific recommendations for high blood pressure management for stroke prevention have been somewhat unclear due to the study design and the quality of the evidence based on clinical study results. Further complicating the assessment process is the consideration of stroke as a primary outcome of randomized control trials. This appraisal and review describes the assessment of the evidence and trial results for management of hypertension and stroke risk reduction with consideration of the impact of The Systolic Blood Pressure Intervention Trial (SPRINT). While evidence clearly identifies the benefit of intense hypertension treatment for the primary and secondary prevention of stroke, evidence gaps still remain.

References

Jan 17, 1977·JAMA : the Journal of the American Medical Association·W R Barclay
Oct 31, 1991·The New England Journal of Medicine·UNKNOWN Dutch TIA Trial Study GroupAnet van Latum
Mar 7, 1970·Lancet·A B Carter
Jul 22, 1974·JAMA : the Journal of the American Medical Association
Oct 1, 1995·Clinical and Experimental Hypertension : CHE·D T LacklandH A Tyroler
Jan 20, 2000·The New England Journal of Medicine·UNKNOWN Heart Outcomes Prevention Evaluation Study InvestigatorsG Dagenais
Feb 24, 2001·Hypertension·Henry R. BlackRobert J. Anders
Feb 28, 2002·JAMA : the Journal of the American Medical Association·Ramachandran S VasanDaniel Levy
Sep 24, 2002·JAMA : the Journal of the American Medical Association·Sverre E KjeldsenUNKNOWN LIFE (Losartan Intervention for Endpoint Reduction) Study Group
May 16, 2003·JAMA : the Journal of the American Medical Association·Aram V ChobanianUNKNOWN National High Blood Pressure Education Program Coordinating Committee
Dec 13, 2003·Stroke; a Journal of Cerebral Circulation·N ChapmanUNKNOWN Writing Committee for the PROGRESS Collaborative Group
Mar 19, 2004·Journal of the American College of Cardiology·Stevo JuliusJackson T Wright
Sep 24, 2004·Hypertension·George L BakrisUNKNOWN INVEST Investigators
Mar 5, 2005·Stroke; a Journal of Cerebral Circulation·Cairu LiLars Janzon
Apr 13, 2005·Blood Pressure·Peter TrenkwalderUNKNOWN Study on COgnition and Prognosis in the Elderly (SCOPE)
Aug 10, 2007·Current Hypertension Reports·Guido GrassiAnd Giuseppe Mancia
Apr 2, 2008·The New England Journal of Medicine·UNKNOWN ONTARGET InvestigatorsCraig Anderson
Apr 26, 2008·BMJ : British Medical Journal·Gordon H GuyattUNKNOWN GRADE Working Group
May 6, 2008·BMJ : British Medical Journal·Gordon H GuyattUNKNOWN GRADE Working Group
Jan 27, 2009·Journal of the American Society of Hypertension : JASH·Daniel T LacklandDaniel L McGee
Sep 16, 2009·PLoS Medicine·Mohammed T AnsariDavid Moher
Oct 22, 2009·International Archives of Medicine·Shaheen E Lakhan, Michael T Sapko
Jan 22, 2010·Circulation·Donald M Lloyd-JonesUNKNOWN American Heart Association Strategic Planning Task Force and Statistics Committee
Mar 17, 2010·The New England Journal of Medicine·William C CushmanFaramarz Ismail-Beigi

❮ Previous
Next ❯

Citations

Jan 27, 2017·Circulation·Emelia J BenjaminUNKNOWN American Heart Association Statistics Committee and Stroke Statistics Subcommittee
Feb 2, 2018·Circulation·Emelia J BenjaminUNKNOWN American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee
Feb 1, 2019·Circulation·Emelia J BenjaminUNKNOWN American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee
Mar 30, 2019·Biomarkers in Medicine·Dirk Theile, William C Cho

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiovascular Disease Pathophysiology

Cardiovascular disease involves several different processes that contribute to the pathological mechanism, including hyperglycemia, inflammation, atherosclerosis, hypertension and more. Vasculature stability plays a critical role in the development of the disease. Discover the latest research on cardiovascular disease pathophysiology here.

Antihypertensive Agents: Mechanisms of Action

Antihypertensive drugs are used to treat hypertension (high blood pressure) which aims to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Discover the latest research on antihypertensive drugs and their mechanism of action here.