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Guidelines recommend, as first-line treatment for hypertension, a diuretic or the combination of diuretic ± ACE inhibito

Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack 2011 Guidelines. 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.

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Guidelines recommend, as first-line treatment for hypertension, a diuretic or the combination of diuretic ± ACE inhibito

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  1. Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack 2011 Guidelines 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 Guidelines recommend, as first-line treatment for hypertension, a diuretic or the combination of diuretic ± ACE inhibitor. 1- Furie K, Kasner S, Adams R, et al. Stroke. 2010;42;227-276.

  2. Prevention of stroke in patients with stroke or transient ischemic attack Antihypertensive medications and secondary prevention of stroke Active treatment arm Study Reduction in stroke Reduction in mortality Indapamide PATS1 -29% P<0.05 -9%* NS Indapamide +perindopril PROGRESS2 -43% P<0.05 -28%** P<0.005 Telmisartan PRoFESS3 -5% NS +3%* NS Eprosartan MOSES4 -25% NS +7%* NS Atenolol Dutch TIA5 -18% NS +12%* NS Ramipril HOPE6 -32% P<0.001 -16%* P=0.005 NS = not significant, *Total death, **Vascular death 1. PATS Collaborating Group. Chin Med J. 1995;108:710-717. 2. PROGRESS Collaborative Group. Lancet. 2001;358:1033-1041. 3. Yusuf S, Diener HC, Sacco RL, et al; PRoFESS Study Group. N Engl J Med. 2008;359:1225-1237. 4. Schrader J, Lüders S, Kulschewski A, et al; MOSES Study Group. Stroke. 2005;36:1218-1224. 5. Dutch TIA study group. Stroke.1993;24:543-548. 6. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med. 2000;342:145-153.

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

  4. Indapamide - the highest protection against stroke In initiation, Natrilix SR (indapamide 1.5 mg SR) reduced stroke by -39%1, as shown by the results of the HYVET trial. 1- Beckett NS, Peters R, Fletcher AE, et al. N Engl J Med. 2008;358:1887-1898.

  5. CONCLUSIONS 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%2in initiation and -43%3in 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. 1- Furie K, Kasner S, Adams R, et al. Stroke. 2010;42;227-276. 2- Beckett NS, Peters R, Fletcher AE, et al. N Engl J Med. 2008;358:1887-1898. 3- PROGRESS Collaborative Group. Lancet. 2001;358:1033–1041.

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