[Anti-hypertensive treatment for primary and secondary prevention of brain attack and failure].

Although anti-hypertensive treatment is known to be effective for preventing first-ever stroke, there has been a long debate, whether this treatment is safe and effective for preventing recurrent stroke and subsequent disabled conditions. PROGRESS trial was designed to clarify these concerns about the efficacy and safety of blood-pressure-lowering treatments for the chronic stroke patients and clearly showed that anti-hypertensive treatment should be quite safe and effective for preventing recurrent stroke. The results of other clinical trials such as HOPE, Syst-Eur2 and SCOPE also suggested the at most importance of anti-hypertensive treatment for primary prevention of cognitive impairment and dementia. In this review, the significance of recent clinical trials were fully discussed in relation to the hypertension-induced pathophysiological changes of the brain.