Stroke therapies in Asian populations

Abstract

In spite of concerns about differing risk factor profiles in patients with stroke in Asian populations, there is some evidence that, for acute stroke therapies and secondary prevention, benefits may be at least equal to the benefits seen in Western countries. Some of the earliest evidence of potential benefits for intravenous tissue plasminogen activator (tPA) using surrogate outcome measures and randomised controlled clinical trial design were shown in a Japanese population, and one of the largest trials of acute stroke therapy was conducted on mainland China—Chinese Acute Stroke Trial (CAST) [Lancet 349 (1997) 1641]. For secondary stroke prevention, both the PATS and Perindopril Protection Against Recurrent Stroke Study (PROGRESS) trials suggested that lowering of blood pressure with either indapamide alone or indapamide+perindopril was as effective or even more so in Asian populations. Generalisation to a broad range of racial groups should be considered when conducting large international trials of stroke therapy.