Cerebral White Matter Lesions, Risk of Stroke and Cerebrovascular Protection with Angiotensin Receptor Blockers

Alejandro   d. l.   Sierra; Cristina      Sierra

Abstract

The pathogenesis and clinical significance of cerebral white matter lesions (WML) remain controversial. Various studies have shown that age, hypertension, diabetes mellitus and a history of stroke or heart disease are the most important factors related to cerebral WML. Other studies suggest that WML are closely related to the development of future strokes and other forms of cerebrovascular disease, such as cognitive impairment, in elderly patients with vascular risk factors, particularly hypertension. Angiotensin receptor blockers are antihypertensive drugs useful for the treatment of hypertension and cardiovascular diseases. Recent data from experimental studies and clinical trials suggest that they could be superior to other antihypertensive therapies in preventing the development of cerebrovascular disease and in reducing the risk of death and recurrences in patients with a previous stroke. This paper reviews the clinical importance of cerebral WML, their relationship with stroke development and data concerning cerebrovascular protection with angiotensin receptor blockers.

Keywords: Cerebral white matter lesions, stroke, angiotensin receptor blockers, hypertension, cerebrovascular disease

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