SECONDARY PREVENTION OF SMALL SUBCORTICAL STROKES (SPS3)

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The overall aim of the Secondary Prevention of Small Subcortical Strokes (SPS3) project is to define efficacious therapies for cerebral small artery disease and its two most common clinical manifestations: small subcortical strokes (S3, also called lacunar strokes) and cognitive decline (vascular dementia). Optimal antiplatelet therapy and antihypertensive management of S3 patients to reduce stroke recurrence and cognitive decline has not been defined and is likely to yield important health benefits. Primary aims are to determine whether combination antiplatelet therapy consisting of aspirin plus clopidogrel is superior to aspirin for reducing recurrent stroke, cognitive decline and major vascular events. Also, to determine whether "intensive" blood pressure lowering to a specific target range is superior to "usual" hypertension management for reducing recurrent stroke, cognitive decline and major vascular events.