Stroke: Antihypertensive combined with statin therapy can effectively prevent stroke onset

Approximately 75% of clinical strokes are first strokes, not recurring events
.

Primary stroke prevention is challenging and requires treatment of a large number of relatively low or medium risk populations.
This is different from secondary prevention, which can easily identify high-risk populations and therefore requires fewer people to be treated
.

In this way, Jackie Bosch and others of McMaster University in Canada reported a secondary analysis of the pre-defined stroke outcomes of each randomized intervention, based on stroke subtypes, independent predictors, treatment effects of key subgroups, and absolute risk reduction.
Analysis
.

They used a 2 by 2 factorial design.
12,705 participants from 21 countries with vascular risk factors but no obvious cardiovascular disease were randomly assigned to 16 mg of candesartan + 12.
5 mg of hydrochlorothiazide per day vs placebo , And rosuvastatin 10 mg vs placebo
.

Participants were 66 years old and 46% were women
.

During the 5.
6 years of follow-up, 169 strokes occurred (117 ischemic, 29 hemorrhagic, and 23 undetermined)
.

Lowering blood pressure did not significantly reduce stroke (hazard ratio [HR], 0.
80[95%CI, 0.
59-1.
08]), ischemic stroke (HR, 0.
80[95%CI, 0.
55-1.
15]), hemorrhagic stroke (HR , 0.
71 [95% CI, 0.
34-1.
48]) or stroke of unknown cause (HR, 0.
92 [95% CI, 0.
41-2.
08])
.

Rosuvastatin can significantly reduce stroke (HR=0.
70, mainly to reduce ischemic stroke (HR=0.
53), but it has no significant effect on hemorrhagic stroke or unexplained stroke
.

The important significance of this study lies in the discovery : in people with moderate cardiovascular risk but no obvious cardiovascular disease, taking 10 mg of rosuvastatin per day can significantly reduce the first stroke
.