Antihypertensive Therapy On The Secondary Prevention Of Recurrence Stroke In Patients: A Meta-analysis

Research backgroundStroke is a major source of the world’s death. There is a high prevalence rate, high case fatality and mutilation rate and high recurrence rate, which serious harm to our health. Nearly 150 ~200 million people have a stroke each year in China, and approximately one quarter of the stroke patients that occur are recurrent events. According to the epidemiological investigation, hypertension is the most important independent risk factors of stroke. The ageing of the population makes hypertensive becoming more serious in our country, company with the growing stroke occurrence. The Guidelines for the prevention and treatment of hypertension China pointed out, effective control of blood pressure can reduce the incidence of stroke events. Although treatment of hypertension is the most important intervention for prevention of stroke. However, there is not enough clinical trials for the antihypertensive agents on stroke secondary prevention, and whether antihypertensive agents all have the same curative effect is unclear. We performed meta-analyses to assess the effectiveness and the safety with antihypertensive drugs on stroke secondary prevention,.ObjectiveTo evaluate the effectiveness and safety for antihypertensive drugs for recurrence stroke outcomes after stroke occur.MethodsThrough the computer, we searched CNKI, VIP, the Cochrane Library, MEDLINE and Embase(last to Dec 2013) for randomized controlled trials(RCT) relating to the antihypertensive agents for secondary stroke prevention,and the reference files with no limit to language. We apply the meta-analysis evaluation software Revman 5.2 and some indicators are calculated by STATA 11.0.ResultsAfter selection, there is 9 randomized controlled trails were eligible for analysis, including 37474 patients in total. The quality of reports of randomized clinical trails reach 5 points a least for the Jadad scores. The statistical effect size shows the agents that lowered blood pressure reduced recurrent stroke 0.74(95%CI,0.60,0.90,P<0.00001)and cardiovascular events 0.79(95%CI,0.67,0.93,P<0.0001) in patients with a previous stroke or TIA. These agents did not affect the rate of myocardial infarction 0.85(95%CI,0.75,0.97,P=0.09) in this patient population. The main reason for withdrawal during the trails were the side-effect of antihypertensive agents.ConclusionEvidence from randomized controlled trials supports the antihypertensive drugs using for patients may effective reduce the risk of stroke recurrence rate and vascular prevention.