Dr. Mercola October 27 2001 1,230 views
By Celia Hall
A "phenomenal" breakthrough in the treatment of stroke patients was announced yesterday after a six-year international study involving 6,000 people, including 700 in Britain.
Repeat strokes, heart attacks and deaths were cut by between a quarter and a third in patients given a combination of two drugs for five years to reduce their blood pressure.
The treatment costs only $75 a year per patient.
Strokes kill 60,000 people in Britain every year and are the biggest single cause of disability. There are 100,000 new strokes a year, 10,000 of them in people under of 55.
Prof John Chalmers, of the Institute for International Health, Sydney, who led the study, said: "This is the best ever news for patients with stroke. Aspirin is pretty good, but this is better.
"The problem with aspirin is that you cannot give it to patients who have had bleeding in the brain, only to patients who had a clotting stroke. We now know that reducing blood pressure is the important thing."
Eion Redahan, the director of communications at the Stroke Association, said the results were "phenomenal". "It is very exciting. This research involved a huge number of people, so it will be statistically relevant."
The study involved patients in Europe, Asia and Australasia, including stroke victims in 23 British hospitals.
They were given perindopril, one of a class of blood pressure drugs called ACE inhibitors which help to dilate blood vessels, allowing blood to flow more freely, and indapamide, a diuretic used to treat water retention and high blood pressure.
Not only did the combination therapy help patients with high blood pressure, but patients with normal blood pressure benefited as well.
Prof Chalmers told the European Society of Cardiology in Stockholm: "As a result of this study, my recommendation is that combination therapy should be considered for all patients, irrespective of the type of stroke, irrespective of blood pressure levels.
"That includes men and women regardless of ethnic group or age. Patients above and below the age of 65 benefited."
More than two-thirds of strokes affect people with normal blood and one in five victims will have another stroke or a heart attack within five years.
As a result of the trials, the reduction of all types of stroke was 28 per cent.
The reduction in major heart attacks, including fatal ones, was 26 per cent and the reduction in non fatal heart attacks was also 26 per cent.
One in 11 of the stroke patients given the ACE inhibitor avoided a heart attack, another stroke or death, whether or not her or she had the diuretic as well.
Among patients whose stroke had involved bleeding in the brain, the reduction in the risk of a heart event or another stroke was as much as 50 per cent.
The study also produced a reduction in the serious consequences of stroke, including disability and dementia.
Prof Chalmers said that treating 11 stroke patients for five years with the two drugs would avoid one major stroke, heart attack or death.
The $75-a-year cost would pay for itself, he said, as treating stroke and heart patients was so expensive. They needed hospital care, after-care, rehabilitation and often nursing home care.
Dr Kim Fox, a cardiologist at the Royal Brompton Hospital, London, which took part in the trials, said: "This is a landmark study in stroke management and cardiovascular disease as a whole."
The Stroke Association said both drugs were prescribed in Britain for high blood pressure. They could be prescribed after strokes by a GP.
However, most people who have had a stroke take only aspirin at the moment and those with normal blood pressure are not given drugs to lower it.
www.News.telegraph.co.uk September 5, 2001
Drugs Aging 2001; 18(3):151-64
Avoiding strokes is an important proactive step towards retaining brain function.
It is important though to not stop any high blood pressure medication immediately as that will clearly increase your risk of stroke.
This is especially important if your systolic blood pressure is greater than 180.
I am not a great fan of using drugs to control symptoms but they certainly seem justified in this situation.
They serve as a useful band-aid to keep the blood pressure normalized until one is able to implement some of the lifestyle suggestions listed below.
I am a bit surprised at the use of an ACE inhibitor to achieve this benefit as I typically use a beta-blocker like atenolol in this situation. However, it appears that this may be another option.
It is not clear if all ACE inhibitors would provide the same benefit. The drug mentioned in this study is not yet available in the US.
The primary treatment for hypertension is having a person make optimal food choices. Sugar, as well as grains, which convert to sugar are the primary mechanism that causes insulin to be released and it is the high insulin levels that are the major factor in elevation of blood pressure.
Stress is the other major mechanism and it can be helped with exercise. I have three therapists in the office who use a large variety of sophisticated energy balancing techniques which are profoundly effective at reversing the damage that stress has on the body.
However, I recently learned of a technique called EFT (Emotional Freedom Technique) that is quite effective and relatively easy to do and learn. It is a much simpler derivative of Dr. Roger Callahan's work with TFT (Thought Field Therapy).
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