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

Autori
Zanchetti, Alberto ; Liu, Lisheng ; Mancia, Giuseppe ; Parati, Gianfranco ; Grassi, Guido ; Stramba-Badiale, Marco ; Silani, Vincenzo ; Bilo, Grzegorz ; Corrao, Giovanni ; Zambon, Antonella ; Scotti, Lorenza ; Zhang, Xinhua ; Wang, HayYan ; Zhang, Yuqing ; Zhang, Xuezhong ; Guan, Ting Rui ; Berge, Eivind ; Redon, Josep ; Narkiewicz, Krzysztof ; Dominiczak, Anna ; Nilsson, Peter ; Viigimaa, Margus ; Laurent, Stéphane ; Agabiti- Rosei, Enrico ; Wu, Zhaosu ; Zhu, Dingliang ; Rodicio, José Luis ; Ruilope, Luis Miguel ; Martell-Claros, Nieves ; Pinto, Fernando ; Schmieder, Roland E ; Burnier, Michel ; Banach, Maciej ; Cifkova, Renata ; Farsang, Csaba ; Konradi, Alexandra ; Lazareva, Irina ; Sirenko, Yuriy ; Dorobantu, Maria ; Postadzhiyan, Arman ; Accetto, Rok ; Jelaković, Bojan ; Lović, Dragan ; Manolis, Athanasios J. ; Stylianou, Philippos ; Erdine, Serap ; Dicker, Dror ; Wei, Gangzhi ; Xu, Chengbin ; Xie, Hengge ; Coca, Antonio ; O’Brien, John ; Ford, Gary

Izvornik
Journal of hypertension (0263-6352) 32 (2014), 9; 1741-1750

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
blood pressure; cognitive decline; low-density lipoprotein cholesterol; primary prevention; secondary prevention; stroke

Sažetak
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. 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. 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.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA