Preventing stroke in hypertensive patients at risk.

Stroke is a leading cause of death and disability worldwide, and despite improvements in healthcare, its incidence is still rising. Elevated blood pressure (BP) is the single most important modifiable risk factor for stroke, doubling stroke risk for each 20 mm Hg increase in systolic blood pressure (SBP). Although BP reduction can lower stroke risk by 30% to 40%, there is mounting evidence that different antihypertensive classes do not provide equal stroke prevention for the same reductions in BP. In comparison with other antihypertensive agents, angiotensin receptor blockers (ARB) provide additional protection against stroke and other cardiovascular outcomes, beyond that explained by reductions in BP alone. One ARB, telmisartan, exhibits properties that may prove especially useful in the prevention of stroke. To this day, telmisartan is being evaluated in a series of large-scale studies, including the Prevention Regimen For Effectively avoiding Second Strokes (PRoFESS) Trial, the world's largest secondary stroke prevention trial. Results from this study will clarify the benefits of telmisartan in secondary stroke prevention and help to determine the most effective approaches for stroke recurrence in high-risk patients.