Guidelines recommend, as first-line treatment for hypertension, a diuretic or the combination of diuretic ± ACE inhibitor. Prevention of Stroke in Patients.

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Presentation transcript:

Guidelines recommend, as first-line treatment for hypertension, a diuretic or the combination of diuretic ± ACE inhibitor. Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack 2011 Guidelines 1- Furie K, Kasner S, Adams R, et al. Stroke. 2010;42; Hypertension is considered as the most important risk factor for stroke. Diuretics or the combination of diuretics and an ACE inhibitor have the highest level of evidence: Class I; Level of Evidence A. 1

Prevention of stroke in patients with stroke or transient ischemic attack 1. PATS Collaborating Group. Chin Med J. 1995;108: PROGRESS Collaborative Group. Lancet. 2001;358: Yusuf S, Diener HC, Sacco RL, et al; PRoFESS Study Group. N Engl J Med. 2008;359: Schrader J, Lüders S, Kulschewski A, et al; MOSES Study Group. Stroke. 2005;36: Dutch TIA study group. Stroke.1993;24: The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med. 2000;342: NS = not significant, *Total death, **Vascular death Antihypertensive medications and secondary prevention of stroke PROGRESS 2 Active treatment arm Study Reduction in stroke Reduction in mortality Indapamide PATS 1 -29% P< % * NS Indapamide + perindopril -43% P< % ** P<0.005 Telmisartan PRoFESS 3 -5% NS +3% * NS Eprosartan MOSES 4 -25% NS +7% * NS Atenolol Dutch TIA 5 -18% NS +12% * NS Ramipril HOPE 6 -32% P< % * P=0.005

In combination, Natrilix (indapamide) reduced stroke by -43% 1, as shown by the results of the PROGRESS trial. Indapamide - the highest protection against stroke 1- PROGRESS Collaborative Group. Lancet. 2001;358:1033–1041

1- Beckett NS, Peters R, Fletcher AE, et al. N Engl J Med. 2008;358: In initiation, Natrilix SR (indapamide 1.5 mg SR) reduced stroke by -39% 1, as shown by the results of the HYVET trial. Indapamide - the highest protection against stroke

The 2011 American Stroke Guidelines recommend as first-line treatment of hypertension a diuretic ± ACE inhibitor. 1 Among diuretics, Natrilix SR, demonstrated the highest protection against stroke: -39% 2 in initiation and -43% 3 in combination with perindopril. The high protection against stroke with Natrilix SR translates into total mortality reduction, in the HYVET trial, total mortality being reduced by –21% 2. CONCLUSIONS 1- Furie K, Kasner S, Adams R, et al. Stroke. 2010;42; Beckett NS, Peters R, Fletcher AE, et al. N Engl J Med. 2008;358: PROGRESS Collaborative Group. Lancet. 2001;358:1033–1041.