Peran Terapi Antihipertensi terhadap Pencegahan Kekambuhan Stroke: Tinjauan Literatur
DOI:
https://doi.org/10.64465/jek.v1i3.129Keywords:
Antihipertensi, Hipertensi, Pencegahan sekunder, Stroke berulang, Tekanan darahAbstract
Stroke berulang merupakan masalah klinis penting karena meningkatkan risiko disabilitas, kematian, dan beban biaya kesehatan. Hipertensi merupakan salah satu faktor risiko utama yang dapat dimodifikasi dalam pencegahan kekambuhan stroke. Kajian pustaka ini bertujuan menganalisis peran terapi antihipertensi dalam mencegah stroke berulang berdasarkan bukti ilmiah terkini. Metode yang digunakan adalah systematic literature review dengan mengacu pada panduan PRISMA. Penelusuran literatur dilakukan melalui PubMed/MEDLINE, Google Scholar, ScienceDirect, dan Cochrane Library menggunakan kata kunci terkait antihypertensive drugs, recurrent stroke, secondary stroke prevention, serta blood pressure lowering. Dari 4.291 artikel yang teridentifikasi, dilakukan penyaringan berdasarkan publikasi lima tahun terakhir, free full text, human studies, usia pasien ≥19 tahun, dan kesesuaian dengan kriteria inklusi. Sebanyak 27 artikel memenuhi kriteria dan dianalisis secara naratif. Hasil kajian menunjukkan bahwa terapi antihipertensi berperan penting dalam pencegahan sekunder stroke. Obat yang paling sering digunakan meliputi ACE inhibitor, angiotensin receptor blocker, calcium channel blocker, serta diuretik thiazide atau thiazide-like. Pada fase akut, penurunan tekanan darah perlu dilakukan secara hati-hati untuk menjaga perfusi otak. Pada fase pasca-stroke, kontrol tekanan darah jangka panjang lebih konsisten menurunkan risiko kekambuhan. Telemonitoring, self-management, edukasi, dan pendampingan perawat juga mendukung kepatuhan dan keberhasilan terapi. Temuan ini menegaskan pentingnya pengendalian hipertensi komprehensif sebagai bagian pencegahan sekunder stroke.
References
Appleton, J. P., Dixon, M., Woodhouse, L. J., Anderson, C. S., Ankolekar, S., Cala, L., ... & RIGHT‐2 Investigators. (2024). Pre‐hospital transdermal glyceryl trinitrate for transient ischaemic attack: Data from the RIGHT‐2 trial. European Journal of Neurology, 31(12), e16502. Available at: https://doi.org/10.1111/ene.16502.
Chalmers, J., Mourad, J. J., Brzozowska-Villatte, R., De Champvallins, M., & Mancia, G. (2023). Benefit of treatment based on indapamide mostly combined with perindopril on mortality and cardiovascular outcomes: a pooled analysis of four trials. Journal of Hypertension, 41(3), 508. Available at: https://doi.org/10.1097/HJH.0000000000003368.
Denny, M. C., Almohamad, M., Ebirim, E., Morell, A., Okpala, M., Hwang, K. O., ... & Sharrief, A. (2025). Blood pressure misclassification among stroke survivors followed in a comprehensive stroke prevention clinic. Journal of Stroke and Cerebrovascular Diseases, 34(5), 108282. Available at: https://doi.org/10.1016/j.jstrokecerebrovasdis.2025.108282.
Ekaputra, A. (2026). Optimalisasi penerapan Standar Akuntansi Keuangan EMKM Dalam Laporan Keuangan UMKM: Systematic Literature Review. Jurnal Entitas Ekonomi Dan Bisnis, 2(1), 29–40. https://doi.org/10.64465/jeeb.v2i1.97.
Ekaputra, A. (2026). Dampak Keuangan Digital Terhadap Pertumbuhan Ekonomi. Jurnal Entitas Ekonomi Dan Bisnis, 2(1), 52–65. https://doi.org/10.64465/jeeb.v2i1.104
Farr, C. V., Ebner, J., Lang, M. B., Zehetmayer, S., Trawnicek, K., Greisenegger, S., ... & Altmann, P. (2025). A randomized controlled pilot study investigating adherence to blood pressure diaries with personal pictures in stroke follow-up care. Wiener klinische Wochenschrift, 137(21), 693-701. Available at: https://doi.org/10.1007/s00508-025-02530-w.
Hsu, C. Y., Saver, J. L., Ovbiagele, B., Wu, Y. L., Cheng, C. Y., & Lee, M. (2023). Association between magnitude of differential blood pressure reduction and secondary stroke prevention: a meta-analysis and meta-regression. JAMA neurology, 80(5), 506-515.. Available at: https://doi.org/10.1001/jamaneurol.2023.0218.
Ibrahim, A. A., Khlidj, Y., Amin, A. M., Rakab, M. S., Manasrah, A., Mahmoud, A., ... & Abuelazm, M. (2025). Pre-hospital blood pressure lowering in presumed hyperacute stroke: A systematic review and meta-analysis of randomized controlled trials. Journal of Stroke and Cerebrovascular Diseases, 34(2), 108158. Available at: https://doi.org/10.1016/j.jstrokecerebrovasdis.2024.108158.
Ingard, K., Irewall, A. L., Mooe, T., & Ögren, J. (2025). Nurse-led secondary preventive follow-up after stroke/TIA and ACS for patients aged 80 years or older: A post-hoc analysis of the randomized controlled NAILED trial. Plos one, 20(11), e0335930. Available at: https://doi.org/10.1371/journal.pone.0335930.
Jumaa, M. A., Gharaibeh, K., Burgess, R. E., Rao, R., Oliver, M. J., Mierzwa, A., ... & Zaidi, S. F. (2026). Clevidipine infusion for blood pressure management after successful revascularisation in acute ischaemic stroke: the CLEVER study. European stroke journal, 11(2), aakag005.
Jung, J. W., Kim, Y. D., Heo, J., Lee, H., Kim, B. M., Kim, D. J., ... & OPTIMAL-BP Trial Investigators. (2025). Association between intravenous antihypertensives and functional outcome after successful endovascular thrombectomy. Stroke, 56(9), 2503-2515. Available at: https://doi.org/10.1161/STROKEAHA.125.051696.
Kleindorfer, D. O., Towfighi, A., Chaturvedi, S., Cockroft, K. M., Gutierrez, J., Lombardi-Hill, D., ... & Williams, L. S. (2021). 2021 guideline for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline from the American Heart Association/American Stroke Association. Stroke, 52(7), e364-e467. Available at: https://doi.org/10.1161/STR.0000000000000375.
Kolmos, M., Christoffersen, L., & Kruuse, C. (2021). Recurrent ischemic stroke–a systematic review and meta-analysis. Journal of Stroke and Cerebrovascular Diseases, 30(8), 105935. Available at: https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.105935.
Lee, D., Emblin, K., Daniels, R., Kallis, T. J., Alallan, M., & Mokbel, K. (2025). Transient ischaemic attack in a patient with Conn syndrome: A case report and literature review on the importance of identifying secondary hypertension. in vivo, 39(1), 566-571. Available at: https://doi.org/10.21873/invivo.13861.
Li, J., Lei, L., Li, Y., Zhang, H., Yan, X., Sun, Y., ... & ESPRIT Collaborative Group. (2025). Effect of intensive blood pressure control on stroke: a prespecified secondary analysis of the ESPRIT trial. Journal of the American College of Cardiology, 86(17), 1405-1417. Available at: https://doi.org/10.1016/j.jacc.2025.07.055.
Liu, F., Ren, X., Chen, C., Ouyang, M., Li, Q., Wang, X., ... & Song, L. (2026). Early blood pressure lowering and cerebral oedema in thrombolysis-treated stroke: secondary analysis of the ENCHANTED trial. Stroke and Vascular Neurology, 11(3).Available at: https://doi.org/10.1136/svn-2025-004463.
McManus, R. J., Smith, A., Temple, E., Yu, L. M., Allen, J., Doogue, R., ... & TASMIN5S investigators. (2024). Self-monitoring of blood pressure following a stroke or transient ischaemic attack (TASMIN5S): a randomised controlled trial. BMC Cardiovascular Disorders, 24(1), 746. Available at: https://doi.org/10.1186/s12872-024-04320-0.
Mistry, E. A., Hart, K. W., Davis, L. T., Gao, Y., Prestigiacomo, C. J., Mittal, S., ... & Khatri, P. (2023). Blood pressure management after endovascular therapy for acute ischemic stroke: the BEST-II randomized clinical trial. Jama, 330(9), 821-831. Available at: https://doi.org/10.1001/jama.2023.14330.
Nam, H. S., Kim, Y. D., Heo, J., Lee, H., Jung, J. W., Choi, J. K., ... & Heo, J. H. (2023). Intensive vs conventional blood pressure lowering after endovascular thrombectomy in acute ischemic stroke: the OPTIMAL-BP randomized clinical trial. Jama, 330(9), 832-842. Available at: https://doi.org/10.1001/jama.2023.14590.
Ngamvitroj, A., Pitthayapong, S., & Dhippayom, T. (2025). Theory-based self-management to improve blood pressure control in stroke survivors: a systematic review and meta-analysis. Journal of Stroke and Cerebrovascular Diseases, 108455. Available at: https://doi.org/10.1016/j.jstrokecerebrovasdis.2025.108455.
Ogedegbe, G., Teresi, J. A., Williams, S. K., Ogunlade, A., Izeogu, C., Eimicke, J. P., ... & Spruill, T. M. (2024). Home blood pressure telemonitoring and nurse case management in Black and Hispanic patients with stroke: a randomized clinical trial. JAMA, 332(1), 41-50. Available at: https://doi.org/10.1001/jama.2024.6609.
Park, T. H., Cho, Y. J., Park, J. M., Lee, K., Lee, M., Lee, J., ... & Bae, H. J. (2024). Contemporary statistics of acute ischemic stroke and transient ischemic attack in 2021: insights from the CRCS-K-NIH registry. Journal of Korean medical science, 39(34). https://doi.org/10.3346/jkms.2024.39.e278
Ren, X., Chen, C., Wang, X., Li, Q., Zhao, Y., You, S., ... & Song, L. (2024). Influence of renal function on blood pressure control and outcome in thrombolyzed patients after acute ischemic stroke: post-hoc analysis of the ENCHANTED trial. Frontiers in Endocrinology, 15, 1341902. Available at: https://doi.org/10.3389/fendo.2024.1341902.
Ridha, M., Hailat, R., Stanton, R., Merkler, A. E., Elkind, M. S., Longstreth Jr, W. T., ... & Woo, D. (2026). Hypertension With High-Risk Features in Cryptogenic Stroke: An Exploratory Analysis of the ARCADIA Randomized Clinical Trial. JAMA neurology, 83(6), 573-581. Available at: https://doi.org/10.1001/jamaneurol.2026.0855.
Sarfo, F. S., Akpalu, A., Bockarie, A. S., Nguah, S. B., Ayisi-Boateng, N. K., Adu Gyamfi, R., ... & Ovbiagele, B. (2026). Phone-Based Intervention Under Nurse Guidance for Control of Hypertension After Stroke: A Randomized Multicenter Phase 3 Trial in Ghana. Circulation, 153(24), 1890-1902. Available at: https://doi.org/10.1161/CIRCULATIONAHA.125.077424.PHONE-BASED.
Sholikhah, M. A., Putriana, R., Zelisma, F. E., & Syahri, S. T. H. (2026). Peran Body butter Berbasis Bahan Alam dalam Menjaga Kesehatan dan Kelembapan Kulit. Jurnal Kesehatan Farmasi Nusantara, 2(1), 38-47.
Sholikhah, M., Putri, K. A., Chairani, S. N., & Septiani, N. (2026). Inovasi formulasi pewarna rambut berbasis bahan alam sebagai alternatif kosmetik yang aman: Systematic review. Jurnal Kesehatan Farmasi Nusantara, 2(1), 48–56. https://doi.org/10.64465/jkfn.v2i1.96
Susilo, A.I. and Pradifta, R. (2025) ‘Profil Pemanfaatan Obat Bahan Alam Sebagai Terapi Komplementer pada Penderita Hipertensi di Kelurahan Lempuing , Kota Bengkulu’, Journal of Innovative and Creativity, 5(3).
Tan, J., Gong, E., Gallis, J. A., Sun, S., Chen, X., Turner, E. L., ... & Yan, L. L. (2024). Primary care–based digital health–enabled stroke management intervention: long-term follow-up of a cluster randomized clinical trial. JAMA Network Open, 7(12), e2449561. Available at: https://doi.org/10.1001/jamanetworkopen.2024.49561.
Teria, N. P., & Sholikhah, M. (2025). Faktor-faktor yang memengaruhi kepatuhan minum obat hipertensi di Kota Palembang. Jurnal Kesehatan Farmasi Nusantara, 1(2), 44–51. https://doi.org/10.64465/jkfn.v1i2.50
Tharmaratnam, D., Karayiannis, C. C., Collyer, T. A., Arima, H., McClure, L. A., Chalmers, J., ... & Srikanth, V. (2021). Is blood pressure lowering in the very elderly with previous stroke associated with a higher risk of adverse events?. Journal of the American Heart Association, 10(24), e022240. Available at: https://doi.org/10.1161/JAHA.121.022240.
Tu, W. J., & Wang, L. D. (2023). China stroke surveillance report 2021. Military Medical Research, 10(1), 33. Available at: https://doi.org/10.1186/s40779-023-00463-x.
Wang, Z., Wang, J., He, L., Jiang, C., Wang, Y., Shen, T., ... & Ma, C. (2025). Intensive Blood Pressure Control in Patients With Diabetes and Previous Stroke: A Post‐Hoc Analysis of ACCORD‐BP Trial. The Journal of Clinical Hypertension, 27(7), e70095. Available at: https://doi.org/10.1111/jch.70095.
Wei, Y., Xie, X., Pan, Y., Wang, M., Wang, A., Liu, D., ... & Liu, L. (2024). Early vs delayed antihypertensive treatment in acute single subcortical infarction: a secondary analysis of the CATIS-2 randomized clinical trial. JAMA Network Open, 7(8), e2430820. https://doi.org/10.1001/jamanetworkopen.2024.30820.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Rahmawati Raising, Oktaviarika Dewi Hermawatiningsih, Lukman La Basy
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
