血壓及膽固醇 | Blood Pressure & Cholesterol

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血壓及膽固醇

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。

血壓及膽固醇的部份醫學研究:

  • 血壓、膽固醇；1,2
  • 全身血管、動脈彈性1,2,3,4
  • 身體組織鈣化（硬化）5,6
  • 甘油三脂（7,8,21）
  • 膽固醇（12,21）
  • 血壓（11,13,14）
  • 血流暢通（9,10,17）
  • 心腦血管健康（15,16,20,21）
  • 動脈血管彈性（18,19,21）


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.


Part of medical research on blood pressure and cholesterol


  • Blood pressure, cholesterol; 1,2
  • Systemic vascular and arterial elasticity 1,2,3,4
  • Calcification (sclerosis) of body tissues 5,6
  • Triglycerides (7,8,21)
  • Cholesterol (12,21)
  • Blood pressure (11,13,14)
  • The blood flow was smooth (9,10,17)
  • Cardiovascular and cerebrovascular health (15,16,20,21)
  • Arterial elasticity (18,19,21)


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