Blood pressure and low-density lipoprotein-cholesterol lowering for prevention of strokes and cognitive decline: a review of available trial evidence

Journal article

Publication Details

Author(s): Zanchetti A, Liu L, Mancia G, Parati G, Grassi G, Stramba-Badiale M, Silani V, Bilo G, Corrao G, Zambon A, Scotti L, Zhang X, Wang H, Zhang Y, Zhang X, Guan TR, Berge E, Redon J, Narkiewicz K, Dominiczak A, Nilsson P, Viigimaa M, Laurent S, Agabiti-Rosei E, Wu Z, Zhu D, Luis Rodicio J, Miguel Ruilope L, Martell-Claros N, Pinto F, Schmieder R, Burnier M, Banach M, Cifkova R, Farsang C, Konradi A, Lazareva I, Sirenko Y, Dorobantu M, Postadzhiyan A, Accetto R, Jelakovic B, Lovic D, Manolis AJ, Stylianou P, Erdine S, Dicker D, Wei G, Xu C, Xie H, Coca A, O'Brien J, Ford G
Journal: Journal of Hypertension
Publication year: 2014
Volume: 32
Journal issue: 9
Pages range: 1741-50
ISSN: 0263-6352
eISSN: 1473-5598


It is well established by a large number of randomized controlled trials that lowering blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) by drugs are powerful means to reduce stroke incidence, but the optimal BP and LDL-C levels to be achieved are largely uncertain. Concerning BP targets, two hypotheses are being confronted: first, the lower the BP, the better the treatment outcome, and second, the hypothesis that too low BP values are accompanied by a lower benefit and even higher risk. It is also unknown whether BP lowering and LDL-C lowering have additive beneficial effects for the primary and secondary prevention of stroke, and whether these treatments can prevent cognitive decline after stroke.A review of existing data from randomized controlled trials confirms that solid evidence on optimal BP and LDL-C targets is missing, possible interactions between BP and LDL-C lowering treatments have never been directly investigated, and evidence in favour of a beneficial effect of BP or LDL-C lowering on cognitive decline is, at best, very weak.A new, large randomized controlled trial is needed to determine the optimal level of BP and LDL-C for the prevention of recurrent stroke and cognitive decline.

FAU Authors / FAU Editors

Schmieder, Roland Prof. Dr.
Professur für Innere Medizin (Nephrologie)

External institutions with authors

Asclepeion Hospital
Beijing Anzhen Hospital
Beijing Xuanwu Hospital
Bucharest Emergency University Hospital
Centro Hospitalar de Entre o Douro e Vouga, E.P.E.
Chinese Hypertension League
Federal Almazov North-West Medical Research Centre
Fuwai Cardiovascular Hospital
Georges Pompidou European Hospital / Hôpital Européen Georges-Pompidou (HEGP)
Hospital Clínico San Carlos
Hospital Universitario 12 de Octubre
Istanbul University / İstanbul Üniversitesi
Istituto Scientifico Ospedale San Luca (Istituto Auxologico Italiano)
Lausanne University Hospital / Centre hospitalier universitaire vaudois (CHUV)
Ljubljana University Medical Centre (Ljubljana UMC) / Univerzitetni klinični center Ljubljana
Lund University / Lunds universitet
M.D. Strazhesko Institute of Cardiology
Medical University Gdansk / Gdański Uniwersytet Medyczny
Medical University of Łódź / Uniwersytet Medyczny w Łodzi
Nicosia General Hospital
Oslo University Hospital / Oslo Universitetssykehus
Oxford University Hospitals NHS Foundation Trust
Peking University (PKU) / 北京大学
Rabin Medical Center / מרכז רפואי רבין‎‎
Respublican Scientific and Practical Center “Cardiology”
St. Imre Teaching Hospital
Tallinn University of Technology
Universidad Complutense de Madrid (UCM)
Università degli Studi di Brescia
Universitat de Barcelona (UB) / University of Barcelona
University Hospital St. Anna
University of Cambridge
University of Glasgow
University of Milano-Bicocca / Università degli Studi di Milano-Bicocca, UNIMIB
University of València / Universitat de València
Univerzita Karlova v Praze / Charles University in Prague
Zagreb University Hospital Centre / Klinički bolnički centar Zagreb (KBC)

How to cite

Zanchetti, A., Liu, L., Mancia, G., Parati, G., Grassi, G., Stramba-Badiale, M.,... Ford, G. (2014). Blood pressure and low-density lipoprotein-cholesterol lowering for prevention of strokes and cognitive decline: a review of available trial evidence. Journal of Hypertension, 32(9), 1741-50.

Zanchetti, Alberto, et al. "Blood pressure and low-density lipoprotein-cholesterol lowering for prevention of strokes and cognitive decline: a review of available trial evidence." Journal of Hypertension 32.9 (2014): 1741-50.


Last updated on 2019-26-07 at 09:03