Blood pressure and low-density lipoprotein-cholesterol lowering for prevention of strokes and cognitive decline: a review of available trial evidence.

Details

Serval ID
serval:BIB_6B00E6772E4C
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Blood pressure and low-density lipoprotein-cholesterol lowering for prevention of strokes and cognitive decline: a review of available trial evidence.
Journal
Journal of Hypertension
Author(s)
Zanchetti A., Liu L., Mancia G., Parati G., Grassi G., Stramba-Badiale M., Silani V., Bilo G., Corrao G., Zambon A., Scotti L., Zhang X., Wang H., Zhang Y., Zhang X., Guan T.R., Berge E., Redon J., Narkiewicz K., Dominiczak A., Nilsson P., Viigimaa M., Laurent S., Agabiti-Rosei E., Wu Z., Zhu D., Rodicio J.L., Ruilope L.M., Martell-Claros N., Pinto F., Schmieder R.E., Burnier M., Banach M., Cifkova R., Farsang C., Konradi A., Lazareva I., Sirenko Y., Dorobantu M., Postadzhiyan A., Accetto R., Jelakovic B., Lovic D., Manolis A.J., Stylianou P., Erdine S., Dicker D., Wei G., Xu C., Xie H., Coca A., O'Brien J., Ford G.
ISSN
1473-5598 (Electronic)
ISSN-L
0263-6352
Publication state
Published
Issued date
2014
Peer-reviewed
Oui
Volume
32
Number
9
Pages
1741-1750
Language
english
Notes
Publication types: Journal ArticlePublication Status: ppublish Document Type: Review
Abstract
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.
Pubmed
Web of science
Create date
19/09/2014 16:51
Last modification date
20/08/2019 14:25
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