Intensive blood pressure and cholesterol lowering to prevent dementia after stroke: a pilot trial

Published date
Tuesday, 24 January, 2017

Published: Tuesday 24 January 2017

Published in the journal, PLOS ONE, a new study sheds light on how feasible it is to conduct a large trial of intensive blood pressure lowering and cholesterol lowering treatment after stroke. It's to see if these prevent patients developing memory and thinking problems (cognitive impairment). In some cases, cognitive impairment can progress and lead to dementia.

Funded by Alzheimer's Society and the Stroke Association, the Prevention of Decline in Cognition After Stroke Trial (PODCAST), aimed to recruit 600 patients to the pilot stage of the trial. However, recruitment was limited due to a number of reasons. The main cause was the cost of the cholesterol lowering drugs used in the study, and the reluctance of NHS commissioning bodies to buy them. Delays and limitations to recruitment were also caused by the additional costs of treating patients who took part in the trial after their participation had finished.

PODCAST recruited 83 patients and the main finding was that it didn't show an association between intensive blood pressure lowering or intensive cholesterol lowering and reduced risk of cognitive problems after stroke. However, the reduced number of patients means that this result may not be reliable and clinical benefits might have shown if sufficient numbers of patients were recruited.

The study was able to show that intensive blood pressure and cholesterol lowering treatment resulted in lower blood pressure levels and cholesterol levels than the standard treatments, and that the intensive treatments are safe to use in patients after stroke.

PODCAST provided some evidence that the intensive treatments could be worth further investigation, and has informed the planning of further study in this area of stroke research.

The research team

The PODCAST research team were led by Professor Philip Bath, Professor of Stroke Medicine, Chair and Head of the Division of Clinical Neuroscience at the University of Nottingham.

Related research

Together with the British Heart Foundation (BHF), the Alzheimer's Society and the Stroke Association have now funded a £2.2 million Priority Programme to address vascular dementia, the second most common form of dementia in the UK.  Research studies from the programme will be awarded later this year.

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