Antihypertensive treatment reduces the relative risk of stroke by 25-47% among treated hypertensive patients, with greater absolute risk reductions seen in the elderly.
Does antihypertensive treatment reduce the risk of stroke in patients with hypertension or a history of cerebrovascular disease?
Treatment of hypertension yields a 25-47% relative risk reduction for stroke, with greater absolute benefits seen in elderly patients.
Effect estimate: RR reduction 25-47%
Hypertension is the most important risk factor in the development of stroke. It is also the risk factor most amenable to treatment. The results from 18 controlled trials show a reduction in relative risk of stroke of 25-47% among treated hypertensive patients. This reduction applies both to the elderly and to younger patients, but the absolute reductions are greater among the elderly and the number of patients with hypertension that need to be treated to prevent a stroke is lower in the elderly because they have a higher risk of stroke. The reductions in relative but not absolute risk appear to be similar for both isolated systolic hypertension and combined systolic and diastolic hypertension in the elderly. The case for antihypertensive treatment in the secondary prevention of stroke is less clear but the results of four clinical trials of antihypertensive treatment among patients with and without hypertension and a history of cerebrovascular disease point to a probable benefit. The results of the PROGRESS trial will elucidate this further.
O'Brien et al. (Sun,) conducted a review in Hypertension and stroke prevention. Antihypertensive treatment vs. Control was evaluated on Stroke (RR reduction 25-47%). Antihypertensive treatment reduces the relative risk of stroke by 25-47% among treated hypertensive patients, with greater absolute risk reductions seen in the elderly.
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