Tags

Type your tag names separated by a space and hit enter

Renin-angiotensin system blockade safely reduces blood pressure in patients with minor ischemic stroke during the acute phase.
J Stroke Cerebrovasc Dis 2010 Nov-Dec; 19(6):435-40JS

Abstract

The ACCESS (Acute Candesartan Cilexetil Therapy in Stroke Survivors) study found that administration of candesartan in the acute phase of stroke confers a long-term benefit in patients who have sustained acute ischemic stroke. This treatment did not significantly reduce blood pressure (BP) during the acute phase, however. We assessed the short-term safety of reducing BP with renin-angiotensin system blockade in hypertensive patients who sustained acute ischemic stroke. Our randomized study compared the effects of 14 days of oral candesartan (4 mg/day), perindopril (4 mg/day), or conventional therapy (topical nitrate only when systolic BP (SBP) was ≥220 mm Hg or diastolic BP (DBP) was ≥120 mm Hg) administered to hypertensive patients within 72 hours of the onset of minor ischemic stroke. We assessed neurologic symptoms using the National Institutes of Health Stroke Scale and the modified Rankin Scale within 72 hours of stroke onset before and after drug therapy. A total of 40 patients completed the protocol. Therapy with candesartan and perindopril reduced SBP/DBP values by 23/11 mm Hg (SBP, P<.01; DBP, P=.07) and 14/0 mm Hg (SBP, P=.07), respectively, compared with conventional treatment. Neurologic symptoms worsened in 2 patients who received perindopril, which has no statistical significance, despite the BP reduction in patients given candesartan or perindopril. Our findings indicate that low doses of candesartan or perindopril safely reduce SBP in hypertensive patients with acute ischemic stroke.

Authors+Show Affiliations

Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan. tnakamur@nij.twmu.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

20702114

Citation

Nakamura, Tomomi, et al. "Renin-angiotensin System Blockade Safely Reduces Blood Pressure in Patients With Minor Ischemic Stroke During the Acute Phase." Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association, vol. 19, no. 6, 2010, pp. 435-40.
Nakamura T, Tsutsumi Y, Shimizu Y, et al. Renin-angiotensin system blockade safely reduces blood pressure in patients with minor ischemic stroke during the acute phase. J Stroke Cerebrovasc Dis. 2010;19(6):435-40.
Nakamura, T., Tsutsumi, Y., Shimizu, Y., & Uchiyama, S. (2010). Renin-angiotensin system blockade safely reduces blood pressure in patients with minor ischemic stroke during the acute phase. Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association, 19(6), pp. 435-40. doi:10.1016/j.jstrokecerebrovasdis.2009.08.006.
Nakamura T, et al. Renin-angiotensin System Blockade Safely Reduces Blood Pressure in Patients With Minor Ischemic Stroke During the Acute Phase. J Stroke Cerebrovasc Dis. 2010;19(6):435-40. PubMed PMID: 20702114.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Renin-angiotensin system blockade safely reduces blood pressure in patients with minor ischemic stroke during the acute phase. AU - Nakamura,Tomomi, AU - Tsutsumi,Yukiko, AU - Shimizu,Yuko, AU - Uchiyama,Shinichiro, Y1 - 2010/08/11/ PY - 2009/01/27/received PY - 2009/07/13/revised PY - 2009/08/15/accepted PY - 2010/8/13/entrez PY - 2010/8/13/pubmed PY - 2011/2/26/medline SP - 435 EP - 40 JF - Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association JO - J Stroke Cerebrovasc Dis VL - 19 IS - 6 N2 - The ACCESS (Acute Candesartan Cilexetil Therapy in Stroke Survivors) study found that administration of candesartan in the acute phase of stroke confers a long-term benefit in patients who have sustained acute ischemic stroke. This treatment did not significantly reduce blood pressure (BP) during the acute phase, however. We assessed the short-term safety of reducing BP with renin-angiotensin system blockade in hypertensive patients who sustained acute ischemic stroke. Our randomized study compared the effects of 14 days of oral candesartan (4 mg/day), perindopril (4 mg/day), or conventional therapy (topical nitrate only when systolic BP (SBP) was ≥220 mm Hg or diastolic BP (DBP) was ≥120 mm Hg) administered to hypertensive patients within 72 hours of the onset of minor ischemic stroke. We assessed neurologic symptoms using the National Institutes of Health Stroke Scale and the modified Rankin Scale within 72 hours of stroke onset before and after drug therapy. A total of 40 patients completed the protocol. Therapy with candesartan and perindopril reduced SBP/DBP values by 23/11 mm Hg (SBP, P<.01; DBP, P=.07) and 14/0 mm Hg (SBP, P=.07), respectively, compared with conventional treatment. Neurologic symptoms worsened in 2 patients who received perindopril, which has no statistical significance, despite the BP reduction in patients given candesartan or perindopril. Our findings indicate that low doses of candesartan or perindopril safely reduce SBP in hypertensive patients with acute ischemic stroke. SN - 1532-8511 UR - https://www.unboundmedicine.com/medline/citation/20702114/Renin_angiotensin_system_blockade_safely_reduces_blood_pressure_in_patients_with_minor_ischemic_stroke_during_the_acute_phase_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1052-3057(09)00170-0 DB - PRIME DP - Unbound Medicine ER -