Efectividad en la prevención del ictus. Datos para afrontar esta pandemia

Cerebrovascular accident (CVA) is one of the main causes of morbidity-mortality in Western countries. It is foreseeable that the number of episodes will increase due to the population aging. This, together with the decrease in mortality due to stroke will lead to the increase of the prevalence of patients who have suffered CVA and its sequels. Thus, prevention should be a priority objective. The most important risk factor due to its prevalence and intensity of association is arterial hypertension, and the decrease of blood pressure (BP) values with any drug is translated into a decrease in stroke risk. However, poor control of BP may be responsible for up to 46% of the strokes occurring. Classical studies show a decrease of 40% of the stroke incidence when BP decreases 10 mmHg. Although all the drugs reduce stroke incidence when compared with placebo, it is not clear if any therapeutic groups are more beneficial than the others. However, the benefit of losartan (± diuretic), that offers an additional increase of stroke risk against the more classical regime of atenolol ± diuretic, has been established in patients with left ventricular hypertrophy. Strict control of BP and use of drugs with proven efficacy, according to the characteristics of each patient, may have a very important impact on the decrease of the incidence of such a devastating disease.