A New Option for Therapeutic Management of Patients with Cerebrovascular Disease

Stroke represents the most devastating cardiovascular (CV) disease in Western countries, accounting for approximately 700 000 cases per year, including 500 000 first attacks and 200 000 recurrent episodes. High blood pressure is the most relevant, modifiable risk factor for developing stroke. Available evidence demonstrates that in hypertensive patients, especially those with additional CV risk factors, organ damage, diabetes mellitus or other clinical conditions, even small decreases in blood pressure levels are associated with large reductions in the incidence of cerebrovascular events, mostly stroke, in a setting of primary prevention. The benefits of blood pressure reductions, however, are not strictly proportional to stroke incidence, and it has been postulated that the different classes of antihypertensive drugs may have specific properties for organ protection and cerebrovascular prevention. In particular, the hypothesis of a higher cerebrovascular protection provided by newer antihypertensive agents with respect to the conventional antihypertensive therapy is an attractive perspective, both in primary and secondary prevention.