Telmisartan ramipril combination therapy reduces strokes and improves cardiac and renal protection in stroke prone spontaneously hypertensive rats

The Influence of Stroke Risk Factors and Comorbidities on Assessment of Stroke Therapies in Humans and Animals

The main driving force behind the assessment of novel pharmacological agents in animal models of stroke is to deliver new drugs to treat the human disease rather than to increase knowledge of stroke pathophysiology. There are numerous animal models of the ischaemic process and it appears that the same processes operate in humans. Yet, despite these similarities, the drugs that appear effective in animal models have not worked in clinical trials. To date, tissue plasminogen activator is the only drug that has been successfully used at the bedside in hyperacute stroke management. Several reasons have been put forth to explain this, but the failure to consider comorbidities and risk factors common in older people is an important one. In this article, we review the impact of the risk factors most studied in animal models of acute stroke and highlight the parallels with human stroke, and, where possible, their influence on evaluation of therapeutic strategies.

The role of RAS modification for primary and secondary stroke prevention

Clinical trial results indicate that the choice of antihypertensive agent can be a determinant of stroke protection, independent of blood pressure (BP) reduction. Angiotensin-converting enzyme inhibitors (ACE-Is) are effective for BP control and stroke protection, but their use may be limited by patient tolerability. Angiotensin receptor blockers appear to provide similar BP control compared with ACE-Is and may also offer the clinician the added benefit of primary and secondary stroke prevention, with the potential for fewer tolerability issues.