ABSTRACT
Patients with carotid stenosis are at a high risk not only of stroke, but also of myocardial infarction. Effective treatment of hypertension substantially reduces the risk of recurrent stroke, and virtually eliminates stroke due to hypertensive small vessel disease. Even normotensive patients who have experienced stroke or TIA will benefit from treatment with ACE inhibitors or angiotensin receptor blockers, but in hypertensive patients, the choice of therapy is most effective when it is aimed at the underlying physiologic mechanism that is driving the hypertension. Among those with resistant hypertension, a high proportion have renovascular hypertension or adrenocortical hypertension. To achieve control in difficult cases it is very helpful to measure plasma renin and aldosterone.
