Benefit of initial dual-therapy on stroke prevention in Chinese hypertensive patients: a real world cohort study

Stroke is one of the leading causes of mortality and disability worldwide (1,2). In China, stroke has surpassed coronary heart disease and become the leading cause of death among adults, with 1,500,000 deaths in 2011 (3). Its mortality in China is 4-5 times higher than that in the United States and European countries, 3.5 times higher than that in Japan, and also higher than those in Thailand, India and other developing countries (4). High blood pressure is the most important risk factor for stroke, which accounts for 40-50% of stroke in Chinese population (5). Effective treatment of hypertension can achieve blood pressure control (6). Many large-scale multi-center randomized controlled studies and meta-analysis have demonstrated that lowering blood pressure in hypertensive patients is fundamental for the prevention of stroke and other cardiovascular events (7-11)