This Article Full Text Full Text (PDF) All Versions of this Article: 48/2/187    most recent 01.HYP.0000231939.40959.60v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Zhang, H. Articles by Staessen, J. A. Search for Related Content PubMed PubMed Citation Articles by Zhang, H. Articles by Staessen, J. A. Pubmed/NCBI databases Medline Plus Health Information High Blood Pressure Stroke Related Collections Cerebrovascular disease/stroke Risk Factors Clinical Studies Embolic stroke Other Stroke Treatment - Medical Epidemiology

(Hypertension. 2006;48:187.)
© 2006 American Heart Association, Inc.

Hypertension Highlights

Blood Pressure Lowering for Primary and Secondary Prevention of Stroke

Haifeng Zhang; Lutgarde Thijs; Jan A. Staessen

From the Studies Coordinating Centre (H.Z., L.T., J.A.S.), Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, University of Leuven, Belgium; and the Department of Cardiology (H.Z.), First Affiliated Hospital, Nanjing Medical University, Nanjing, China.

Correspondence to Jan A. Staessen, Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, Campus Gasthuisberg, University of Leuven, Herestraat 49, Box 702, B-3000 Leuven, Belgium. E-mail jan.staesssen@med.kuleuven.be

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Hypertension affects from 20% to 30% of the world population.^1,2 Blood pressure is the most consistent and powerful predictor of stroke. Population mortality trends for stroke parallel those in hypertension.^3,4 A systolic blood pressure >115 mm Hg explains 60% of the population-attributable risk of stroke.⁵ In the Framingham cohort,⁶ the lifetime risk of stroke at ages 55, 65, and 75 years was similar, approximating 1 in 5 for women and 1 in 6 for men. In many countries, such as China,⁷ stroke is the third cause of death only preceded by heart disease and total cancer. Two thirds of stroke deaths occur in developing nations.⁸ According to recent estimates published by the World Health Organization, worldwide, &15 million people per year fall victim to a stroke, of whom &5 million die and another &5 million are left permanently disabled.¹ From this vantage point, we reviewed the recent literature to underscore the deadly but reversible link between stroke and blood pressure.

	Role of Blood Pressure Among Other Risk Factors

 
Nonmodifiable Risk Factors
Nonwhite ethnicity, male sex, older age, and a positive family history are among the nonmodifiable risk factors of stroke.^9,10 Monogenic stroke disorders,¹¹ such as, for instance, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy,¹² are extremely rare. In the vast majority of cases, stroke has a polygenic background associated with proven or suspected variation in the genes contributing to hypertension, carotid intima-media thickness, vascular remodeling, small vessel disease,¹³ inflammation, oxidative stress, dyslipidemia, or the generation of angiotensin II.^14,15 Small vessel disease of the brain underlies 20% to 30% of . . . [Full Text of this Article]

This article has been cited by other articles:

				M R Law, J K Morris, and N J Wald Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies BMJ, May 19, 2009; 338(may19_1): b1665 - b1665. [Abstract] [Full Text] [PDF]

				L. Castilla-Guerra, M. del Carmen Fernandez-Moreno, and M. D. Jimenez-Hernandez Blockage of the Renin-Angiotensin System in the Secondary Prevention of Stroke: Beneficial Effects Beyond Blood Pressure Reduction? Stroke, March 1, 2009; 40(3): e75 - e75. [Full Text] [PDF]

				P. Talelli and R. J. Greenwood Review: Recurrent stroke: where do we stand with the secondary prevention of noncardioembolic ischaemic strokes? Therapeutic Advances in Cardiovascular Disease, October 1, 2008; 2(5): 387 - 405. [Abstract] [PDF]

				B. Williams The Year in Hypertension J. Am. Coll. Cardiol., May 6, 2008; 51(18): 1803 - 1817. [Full Text] [PDF]

				C. S. Rigsby, A. E. Burch, S. Ogbi, D. M. Pollock, and A. M. Dorrance Intact female stroke-prone hypertensive rats lack responsiveness to mineralocorticoid receptor antagonists Am J Physiol Regulatory Integrative Comp Physiol, October 1, 2007; 293(4): R1754 - R1763. [Abstract] [Full Text] [PDF]

				J. A Staessen and E. O'Brien Will generic hypertension guidelines reduce the proliferation of directives? Heart, July 1, 2007; 93(7): 775 - 777. [Full Text] [PDF]

				J. Redon, L. Cea-Calvo, J. V. Lozano, J. C. Marti-Canales, J. L. Llisterri, J. Aznar, J. Gonzalez-Esteban, and on behalf of the investigators of the PREV-ICTUS S Differences in Blood Pressure Control and Stroke Mortality Across Spain: The Prevencion de Riesgo de Ictus (PREV-ICTUS) Study Hypertension, April 1, 2007; 49(4): 799 - 805. [Abstract] [Full Text] [PDF]

				F. H. Messerli and J. A. Staessen Amlodipine Better Than Lisinopril?: How One Randomized Clinical Trial Ended Fallacies From Observational Studies Hypertension, September 1, 2006; 48(3): 359 - 361. [Full Text] [PDF]