Antihypertensive therapy and cerebrovascular protection

PURPOSE OF REVIEW: Stroke represents the most devastating cardiovascular disease in the Western world, accounting for approximately 700 000 cases each year, including 500 000 first attacks and 200 000 recurrent episodes. High blood pressure is the most relevant modifiable risk factor for developing stroke. RECENT FINDINGS: In hypertensive patients, especially those with additional cardiovascular risk factors or clinical settings such as diabetes, target organ damage or associated clinical conditions, even small decreases in blood pressure levels are associated with large reductions in the incidence of cerebrovascular events. The benefits of blood pressure reductions, however, are not strictly proportional to stroke incidence, and it has been recently postulated that the different classes of antihypertensive drugs may have specific properties for organ protection and cerebrovascular accident prevention. SUMMARY: 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 that deserves further investigation.