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Blood pressure lowering helpful after stroke
Last Updated: 2005-09-06 16:00:32 -0400 (Reuters Health)
By Anthony J. Brown, MD
NEW YORK (Reuters Health) - After people suffer a stroke, lowering their
blood pressure can slow or even stop the progression of lesions in the
brain, new research suggests. The areas of damage are called white
matter hyperintensities, or WMHs, because they show up brightly on MRI,
and they have been linked to the development of dementia and depression.
"Several studies have linked WMHs with hypertension, but it was unknown
if blood pressure lowering could slow the progression of these lesions,"
Dr. Christophe Tzourio, from Hopital La Salpetriere in Paris, told
Reuters Health.
Tzourio and his colleague evaluated 192 subjects with stroke who were
enrolled in a trial that examined the benefits of blood
pressure-lowering to prevent repeat strokes. As part of the study, the
subjects were given an ACE-inhibitor alone or in combination with a
diuretic, or an inactive placebo.
MRI was performed at the beginning of the study and at about 36 months,
to assess and grade WMHs, according to the report in the American Heart
Association's journal Circulation.
At follow-up, subjects treated with active agents had a significant drop
in blood pressure compared with those given placebo. Treatment with
antihypertensive agents cut the risk of new WMHs by 43 percent and was
associated with a drop in WMH volume, the team found.
"Although we've not demonstrated that blood pressure-lowering stops
dementia in these patients, it seems logical that if it slows the
progression of WMHs, it would also help prevent dementia," Tzourio noted.
SOURCE: Circulation 2005
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