6533b7dafe1ef96bd126e0f5
RESEARCH PRODUCT
Blood pressure and low-density lipoprotein-cholesterol lowering for prevention of strokes and cognitive decline: a review of available trial evidence.
Ting Rui GuanMaciej BanachRenata CifkovaDror DickerRok AccettoZhaosu WuNieves Martell-clarosPhilippos StylianouGangzhi WeiPeter M. NilssonLisheng LiuLorenza ScottiVincenzo SilaniFernando PintoAntonella ZambonIrina LazarevaMaria DorobantuChengbin XuHayyan WangXuezhong ZhangXin-hua ZhangGrzegorz BiloArman PostadzhiyanAnna F. DominiczakLuis M. RuilopeDingliang ZhuGianfranco ParatiJohn T. O'brienYuriy SirenkoGuido GrassiCsaba FarsangAntonio CocaSerap ErdineMargus ViigimaaKrzysztof NarkiewiczStéphane LaurentGiuseppe ManciaYuqing ZhangAlberto ZanchettiMichel BurnierBojan JelakovićGary A. FordGiovanni CorraoJose L. RodicioAlexandra KonradiHengge XieAthanasios J. ManolisEivind BergeEnrico Agabiti-roseiRedon JosepDragan LovicRoland E. SchmiederMarco Stramba-badialesubject
Malemedicine.medical_specialtyPhysiologyHypercholesterolemiaLow density lipoprotein cholesterolBlood Pressurelaw.inventionCognitionRandomized controlled triallawRecurrenceInternal medicineblood pressure cognitive decline low-density lipoprotein cholesterol primary prevention secondary prevention strokeInternal MedicineSecondary PreventionMedicineHumansCognitive declineStrokeBeneficial effectsRandomized Controlled Trials as TopicSecondary preventionbusiness.industryMED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARECholesterol LDLmedicine.diseasePrimary PreventionStrokeBlood pressureCholesterolCardiologyPhysical therapylipids (amino acids peptides and proteins)Cardiology and Cardiovascular MedicinebusinessStroke incidenceCognition Disordersblood pressure; cognitive decline; low-density lipoprotein cholesterol; primary prevention; secondary prevention; strokedescription
BACKGROUND AND OBJECTIVES:: It is well established by a large number of randomized controlled trials that lowering blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) by drugs are powerful means to reduce stroke incidence, but the optimal BP and LDL-C levels to be achieved are largely uncertain. Concerning BP targets, two hypotheses are being confronted: first, the lower the BP, the better the treatment outcome, and second, the hypothesis that too low BP values are accompanied by a lower benefit and even higher risk. It is also unknown whether BP lowering and LDL-C lowering have additive beneficial effects for the primary and secondary prevention of stroke, and whether these treatments can prevent cognitive decline after stroke. RESULTS:: A review of existing data from randomized controlled trials confirms that solid evidence on optimal BP and LDL-C targets is missing, possible interactions between BP and LDL-C lowering treatments have never been directly investigated, and evidence in favour of a beneficial effect of BP or LDL-C lowering on cognitive decline is, at best, very weak. CONCLUSION:: A new, large randomized controlled trial is needed to determine the optimal level of BP and LDL-C for the prevention of recurrent stroke and cognitive decline.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2014-01-01 | Journal of hypertension |