Stroke: physical and financial pathology

doi:10.1136/bmj.324.7339.0/h

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Most BMJ readers will have studied pathology but forgotten most of what they knew. You don't, however, need to be much of a pathologist to see the infarct that scars the brain on the cover (or on the homepage of bmj.com). Such a stroke is something to be avoided, and a trial on p 699 shows that the angiotensin converting enzyme inhibitor ramipril will reduce by a third the risk of stroke and transient ischaemic attacks in patients with high cardiovascular risk. Hypertension is the major risk factor for stroke, but, as an editorial discusses (p 687), ramipril reduces the risk of …