Acta clinica Croatica, Vol. 43 No. 3, 2004.
Case report
The Role of New Antihypertensive Drugs in Stroke Prevention
Ljiljana Čengić
Marijana Lisak
Zlatko Trkanjec
Vida Demarin
Abstract
There is no doubt that treatment of hypertension has a significant role in the prevention of stroke. Recently published data from large, randomized clinical trials show that lowering of blood pressure is associated with a significant decrease in the risk of stroke. Reduction in the risk of stroke varies from approximately one quarter to approximately one third, depending on the study. Furthermore, besides blood pressure lowering it seems that the use of angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers and calcium antagonists could provide some additional beneficial effects. ACE inhibitors and angiotensin receptor blockers could improve endothelial function, cardiac and vascular remodeling, thus retarding the progression of atherosclerosis. Calcium antagonists, especially the highly lipophilic ones, may have some antioxidant properties. They reduce the oxidation of low-density lipoprotein (LDL) cholesterol and its influx into the arterial wall. Amlodipine, lacidipine or nifedipine suppress platelet production in hypertensive patients. Therefore, ACE inhibitors, angiotensin receptor blockers and calcium antagonists could be potential antiatherosclerotic agents. Considering all these data, it could be assumed that a wider use of these drug classes could significantly improve our ability to prevent all vascular diseases, stroke in particular. Data from recently published large randomized clinical trials shed bright light on stroke prevention in the forthcoming future.
Keywords
Blood pressure - drug effects; Cerebrovascular accident - prevention and control; Hypertension - drug therapy; Antihypertensive agents - therapeutic use
Hrčak ID:
14538
URI
Publication date:
1.9.2004.
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