血壓及膽固醇 | Blood Pressure & Cholesterol
如你有此疾病,請遵照閣下醫生的完整醫療方案;而是否使用多學科復康方案前,你必須咨詢主診醫生的意見,如果閣下的主診醫生不建議您加入補充劑調理組合,請你不要使用。如果你需要尋求其他醫生作第二咨詢,閣下可聯絡我們線上<無邊界醫生>。或你自己城市內的其他專業醫生的再診斷。
背景與目的：大量隨機對照試驗證實，藥物降壓和低密度脂蛋白膽固醇（LDL-C）是降低腦卒中發病率的有效手段，但要達到最佳的血壓和LDL-C水准尚不確定。關於血壓目標，有兩個假說面臨：第一，血壓越低，治療效果越好；第二，血壓值過低會帶來較低的收益，甚至更高的風險。降低血壓和低密度脂蛋白膽固醇是否對中風的一級和二級預防有額外的有益作用，以及這些治療是否能預防中風後認知能力的下降，現時還不清楚。
結果：對現有隨機對照試驗數據的回顧證實，關於最佳血壓和低密度脂蛋白膽固醇靶點的確鑿證據缺失，血壓和低密度脂蛋白膽固醇降低治療之間可能的相互作用從未被直接研究過，支持降血壓或低密度脂蛋白膽固醇對認知能力下降有益的證據充其量是，非常虛弱。
結論：需要一個新的、大規模的隨機對照試驗來確定血壓和低密度脂蛋白膽固醇（LDL-C）在預防腦卒中復發和認知功能下降方面的最佳水准。
Blood Pressure & Cholesterol
Background and objectives: It is well established by a large number of randomized controlled trials that lowering blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) by drugs are powerful means to reduce stroke incidence, but the optimal BP and LDL-C levels to be achieved are largely uncertain. Concerning BP targets, two hypotheses are being confronted: first, the lower the BP, the better the treatment outcome, and second, the hypothesis that too low BP values are accompanied by a lower benefit and even higher risk. It is also unknown whether BP lowering and LDL-C lowering have additive beneficial effects for the primary and secondary prevention of stroke, and whether these treatments can prevent cognitive decline after stroke.
Results: A review of existing data from randomized controlled trials confirms that solid evidence on optimal BP and LDL-C targets is missing, possible interactions between BP and LDL-C lowering treatments have never been directly investigated, and evidence in favour of a beneficial effect of BP or LDL-C lowering on cognitive decline is, at best, very weak.
Conclusion: A new, large randomized controlled trial is needed to determine the optimal level of BP and LDL-C for the prevention of recurrent stroke and cognitive decline.
If you have this disease, please follow your doctor's complete medical plan. You must consult the attending doctor before using the multidisciplinary rehabilitation plan. If your attending doctor does not recommend you to join the supplement conditioning combination, please do not use it. If you need to seek second opinion from other doctors, you can contact our online "Doctors Without Borders", or another professional doctor in your own city.
