Tags

Type your tag names separated by a space and hit enter

Lisinopril for the treatment of hypertension within the first 24 hours of acute ischemic stroke and follow-up.
Am J Hypertens 2007; 20(3):270-7AJ

Abstract

BACKGROUND

Hypertension immediately after acute ischemic stroke is associated with impaired morbidity and mortality, although there are few data on antihypertensive use immediately after ictus. This randomized, double-blinded, placebo-controlled, parallel-group study explored the hemodynamic effect and safety of oral lisinopril initiated within 24 h after an ictus.

METHODS

Forty hypertensive (systolic blood pressure [BP] >/=140 or diastolic BP >/=90 mm Hg) acute ischemic stroke patients (14 lacunar, 13 partial anterior, 7 total anterior, 6 posterior circulation infarct) were randomized to 5 mg of oral lisinopril (n = 18) or matching placebo (n = 22). Dose was increased to 10 mg (or 2 x placebo) on day 7 if casual systolic BP was >/=140 mm Hg and continued to day 14. After the initial dose, automated BP levels were monitored for 16 h. The BP levels and stroke outcome measures were assessed at day 14, and all patients were followed to day 90.

RESULTS

At h 4 after the first dose, systolic/diastolic BP change was -20 +/- 21/-6 +/- 10 mm Hg (mean +/- SE) in the lisinopril group and 1 +/- 11/0 +/- 8 mmHg in the placebo group (group differences: systolic BP, P < .05; diastolic BP, P = .07). With a daily dosing regime, systolic BP, mean arterial pressure (MAP), diastolic BP, and pulse pressure (PP) were significantly lower in the lisinopril group compared to the placebo group at day 14 (P < .01). Neurologic and functional measures were similar between groups at follow-up.

CONCLUSIONS

Lisinopril, even at small dosages, is well tolerated and an effective hypotensive agent after acute ischemic stroke, gradually reducing BP by 4 h after oral first-dose administration. Oral lisinopril is now being studied in a larger outcome-based trial in acute hypertensive stroke patients.

Authors+Show Affiliations

Division of Ageing and Stroke Medicine, Department of Cardiovascular Sciences, Leicester Warwick Medical School, Glenfield Hospital, Leicester, United Kingdom. dje7@le.ac.ukNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial, Phase II
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17324738

Citation

Eveson, David J., et al. "Lisinopril for the Treatment of Hypertension Within the First 24 Hours of Acute Ischemic Stroke and Follow-up." American Journal of Hypertension, vol. 20, no. 3, 2007, pp. 270-7.
Eveson DJ, Robinson TG, Potter JF. Lisinopril for the treatment of hypertension within the first 24 hours of acute ischemic stroke and follow-up. Am J Hypertens. 2007;20(3):270-7.
Eveson, D. J., Robinson, T. G., & Potter, J. F. (2007). Lisinopril for the treatment of hypertension within the first 24 hours of acute ischemic stroke and follow-up. American Journal of Hypertension, 20(3), pp. 270-7.
Eveson DJ, Robinson TG, Potter JF. Lisinopril for the Treatment of Hypertension Within the First 24 Hours of Acute Ischemic Stroke and Follow-up. Am J Hypertens. 2007;20(3):270-7. PubMed PMID: 17324738.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lisinopril for the treatment of hypertension within the first 24 hours of acute ischemic stroke and follow-up. AU - Eveson,David J, AU - Robinson,Thompson G, AU - Potter,John F, PY - 2006/05/23/received PY - 2006/07/12/revised PY - 2006/08/04/accepted PY - 2007/2/28/pubmed PY - 2007/4/21/medline PY - 2007/2/28/entrez SP - 270 EP - 7 JF - American journal of hypertension JO - Am. J. Hypertens. VL - 20 IS - 3 N2 - BACKGROUND: Hypertension immediately after acute ischemic stroke is associated with impaired morbidity and mortality, although there are few data on antihypertensive use immediately after ictus. This randomized, double-blinded, placebo-controlled, parallel-group study explored the hemodynamic effect and safety of oral lisinopril initiated within 24 h after an ictus. METHODS: Forty hypertensive (systolic blood pressure [BP] >/=140 or diastolic BP >/=90 mm Hg) acute ischemic stroke patients (14 lacunar, 13 partial anterior, 7 total anterior, 6 posterior circulation infarct) were randomized to 5 mg of oral lisinopril (n = 18) or matching placebo (n = 22). Dose was increased to 10 mg (or 2 x placebo) on day 7 if casual systolic BP was >/=140 mm Hg and continued to day 14. After the initial dose, automated BP levels were monitored for 16 h. The BP levels and stroke outcome measures were assessed at day 14, and all patients were followed to day 90. RESULTS: At h 4 after the first dose, systolic/diastolic BP change was -20 +/- 21/-6 +/- 10 mm Hg (mean +/- SE) in the lisinopril group and 1 +/- 11/0 +/- 8 mmHg in the placebo group (group differences: systolic BP, P < .05; diastolic BP, P = .07). With a daily dosing regime, systolic BP, mean arterial pressure (MAP), diastolic BP, and pulse pressure (PP) were significantly lower in the lisinopril group compared to the placebo group at day 14 (P < .01). Neurologic and functional measures were similar between groups at follow-up. CONCLUSIONS: Lisinopril, even at small dosages, is well tolerated and an effective hypotensive agent after acute ischemic stroke, gradually reducing BP by 4 h after oral first-dose administration. Oral lisinopril is now being studied in a larger outcome-based trial in acute hypertensive stroke patients. SN - 0895-7061 UR - https://www.unboundmedicine.com/medline/citation/17324738/Lisinopril_for_the_treatment_of_hypertension_within_the_first_24_hours_of_acute_ischemic_stroke_and_follow_up_ L2 - https://academic.oup.com/ajh/article-lookup/doi/10.1016/j.amjhyper.2006.08.005 DB - PRIME DP - Unbound Medicine ER -