Vascular Biology in Clinical Practice © Vol. 4, No. 6
• Prevention of stroke and cognitive dysfunction
This monograph, Prevention of stroke and cognitive dysfunction
, is offered as part of a series of continuing medical education programs from the University of Florida College of Medicine. Guest editors are Carl J. Pepine, MD, University of Florida College of Medicine and Gary H. Gibbons, MD, Morehouse School of Medicine.
Stroke is a serious and increasing public health problem. Although hypertension is the major risk factor for stroke, many stroke victims have normal blood pressure. This suggests that prevention efforts focused on lowering blood pressure in hypertensive patients may overlook many patients who are likely to become stroke victims. The most common cause of stroke is atherosclerosis, and the realization that atherosclerosis is a disease of chronic inflammation has led to the identification of a number of novel risk factors and treatments for stroke. In addition to antithrombotic agents, statins and ACE inhibitors have emerged as important new therapies for stroke prevention.
Recent clinical trials discussed in the monograph show that ACE inhibitors reduce the risk of a first or recurrent stroke in high-risk patients with normal blood pressure as well as in those with hypertension. The results of these studies also show a potential role for ACE inhibition in the reduction in stroke-related functional and cognitive impairment. The monograph examines the mechanisms that may be responsible for these clinical effects.