Lackland Daniel T, Voeks Jenifer H, Boan Andrea D
a Division of Translational Neuroscience and Population Studies, Department of Neurology , Medical University of South Carolina , Charleston , SC 29425 , USA.
Expert Rev Cardiovasc Ther. 2016;14(5):609-16. doi: 10.1586/14779072.2016.1143359. Epub 2016 Feb 12.
While elevated blood pressure has long been associated with cardiovascular and renal outcomes, the association of hypertension and increased stroke risks is perhaps the strongest and best recognized. Furthermore, the reduction of blood pressure with antihypertensive agents has been well documented with lower stroke risks. The specific recommendations for high blood pressure management for stroke prevention have been somewhat unclear due to the study design and the quality of the evidence based on clinical study results. Further complicating the assessment process is the consideration of stroke as a primary outcome of randomized control trials. This appraisal and review describes the assessment of the evidence and trial results for management of hypertension and stroke risk reduction with consideration of the impact of The Systolic Blood Pressure Intervention Trial (SPRINT). While evidence clearly identifies the benefit of intense hypertension treatment for the primary and secondary prevention of stroke, evidence gaps still remain.
长期以来，血压升高一直与心血管和肾脏疾病相关联，而高血压与中风风险增加之间的关联或许最为显著且广为人知。此外，使用抗高血压药物降低血压已被充分证明可降低中风风险。由于研究设计以及基于临床研究结果的证据质量问题，关于预防中风的高血压管理的具体建议一直不太明确。将中风视为随机对照试验的主要结果，这使得评估过程更加复杂。本评估与综述描述了在考虑收缩压干预试验（SPRINT）影响的情况下，对高血压管理及降低中风风险的证据和试验结果的评估。虽然证据明确表明强化高血压治疗对中风的一级和二级预防有益，但证据空白仍然存在。
