Hypertension and dyslipidemia treament in stroke

• Published in: Vnitřní lékar̆stvĭ Vol. 68; no. 3; p. 172
• Main Author: Nussbaumerová, Barbora
• Format: Journal Article
• Language: Czech
• Published: Czech Republic 01.10.2022
• Subjects: Angiotensin Receptor Antagonists - therapeutic use; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Antihypertensive Agents - therapeutic use; Brain Ischemia; Calcium Channel Blockers - adverse effects; Cholesterol, LDL; Dyslipidemias - complications; Dyslipidemias - drug therapy; Ezetimibe - therapeutic use; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hypertension - complications; Hypertension - drug therapy; Indapamide - therapeutic use; Stroke - complications; Stroke - prevention & control; arterial hypertension; PCSK9-i; PCSK9i; cardiovascular disease; secondary prevention; statin; ezetimibe; Antihypertensive drugs; combination therapy; dyslipidemia; stroke; hypolipidemic drugs
• ISSN: 0042-773X
• DOI: 10.36290/vnl.2022.034

Stroke is the second most common cause of mortality worldwide and the third most common cause of disability. Arterial hypertension is the most prevalent risk factor for stroke. A precise management of arterial hypertension prevents the first episode of stroke and the recurrence. Blood pressure must be decreased carefully and not very vigorously in the acute phase of the stroke. Recommended blood pressure goals in chronic tratment are at least 140 / 90 mm Hg and lower if tolerated. ACE inhibitors or angiotensin receptor blockers in combination with calcium channel blockers or indapamide are favorable antihypertensive drugs. Dyslipidemia is also a strong risk factor for ischaemic stroke and has no relatioship to the other etiologies of stroke. The cardiovascular risk in patients after a stroke is very high. An intensive hypolipidemic treatment by statins, ezetimibe and PCSK9i to LDL-cholesterol goals < 1,4 mmol/l and a 50% decrease was proved to decrease the incidence of recurrent stroke.