[Lowering blood pressure--preventing 4 out of 10 strokes. Fully utilizing antihypertensive therapy].

The greatest profit of antihypertensive drug therapy consists in avoiding stroke. The blood pressure aimed at should be below 140/90 mmHg, in diabetic patients below 135/80 mmHg. There exist no special recommendations concerning the choice between the various antihypertensive drugs in use. As a matter of fact, it is advantageous to use in diabetic patients primarily ACE-inhibitors, if necessary in combination with calcium-antagonists. The profit of antihypertensive therapy in avoiding stroke is also proved among elderly patients. All vascular risks should be treated. In case of atrial fibrillation and of asymptomatic high-grade restriction of the carotic artery the indication for a surgical treatment respectively for a therapy with antiaggregating drugs should be considered. Secondary prevention: Hypertension after a cerebral ischemia increases the risk of a recurrent ischemic event. Antihypertensive therapy may probably reduce the risk of a recurrent stroke. Analyses performed so far are only incomplete on this subject. For the first time, the PROGRESS-study will show exact data. Special recommendations concerning the choice between the various antihypertensive drugs in use do not exist neither. Therefore, the recommendations of the German Hypertension League for secondary prevention correspond with those for primary prevention. Hypertension increases the risk of developing dementia. Antihypertensive therapy may apparently reduce significantly the risk of developing dementia. A further important aspect is non-dipping at sleep which is correlated with a worse prognosis of patients.