A systematic review of angiotensin receptor blockers in preventing stroke

Stroke. 2009 Dec;40(12):3876-8. doi: 10.1161/STROKEAHA.109.559989. Epub 2009 Nov 5.


Background and purpose: Angiotensin receptor blockers are widely used in patients at high risk of cardiocerebrovascular events. The aim of this meta-analysis was to investigate the effects of angiotensin receptor blockers on the risk of stroke.

Methods: Electronic searches of MEDLINE, EMBASE, and the Cochrane central register of controlled trials were performed. A total of 20 randomized clinical trials with 108 286 patients reporting stroke were available for this clinical outcome analysis.

Results: Angiotensin receptor blockers were associated with a significant reduction in the risk of stroke than placebo with an OR of 0.91 (0.84 to 0.98). Angiotensin receptor blockers were associated with no significant reduction in the risk of stroke compared with angiotensin-converting enzyme inhibitors (OR, 0.93; 0.84 to 1.03) and calcium antagonists (OR, 1.16; 0.91 to 1.48).

Conclusions: Evidence of the benefit of angiotensin receptor blockers on the risk of stroke is provided when compared with placebo. There was no evidence of the benefit when comparing angiotensin receptor blockers with angiotensin-converting enzyme inhibitors and with calcium antagonists.

Publication types

  • Letter
  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Angiotensin II / antagonists & inhibitors*
  • Angiotensin II / physiology*
  • Angiotensin Receptor Antagonists*
  • Angiotensin-Converting Enzyme Inhibitors / pharmacology
  • Calcium Channel Blockers / pharmacology
  • Cardiovascular Diseases / drug therapy
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular Diseases / prevention & control
  • Humans
  • Hypertension / complications
  • Hypertension / drug therapy
  • Hypertension / prevention & control
  • Randomized Controlled Trials as Topic / statistics & numerical data
  • Receptors, Angiotensin / physiology*
  • Risk Factors
  • Stroke / drug therapy*
  • Stroke / physiopathology
  • Stroke / prevention & control*
  • Treatment Outcome


  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Calcium Channel Blockers
  • Receptors, Angiotensin
  • Angiotensin II