Which classes of antihypertensive agents have been found to offer protection against stroke beyond their BP-lowering effects?
Meta-analyses have evaluated whether specific classes of antihypertensive agents offer protection against stroke beyond their BP-lowering effects. Thiazide diuretics (RR, 0.63; 95% CI, 0.41 0.84) and calcium channel blockers (RR, 0.58; 95% CI, 0.41 0.84) have both been found to reduce the risk of stroke compared with placebo or no treatment. Subgroup analyses from 1 major trial suggest that the benefit of diuretic therapy over ACEI therapy is especially prominent in blacks, and sub-group analysis from another large trial found that -blockers were significantly less effective than thiazide diuretics and ARBs at preventing stroke in those 65 years of age than in younger patients.