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Stroke

Are antihypertensives beneficial in acute stroke?

Increased blood pressure is associated with poor outcomes in acute stroke, but studies assessing the use of antihypertensive agents have been inconclusive. The recent SCAST trial has found that the angiotensin receptor blocker candesartan does not benefit patients with acute stroke and elevated blood pressure, and might even be harmful.

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References

  1. Adams, H. P. et al. Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: the American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Stroke 38, 1655–1711 (2007).

    Article  Google Scholar 

  2. Oliveira-Filho, J. et al. Detrimental effect of blood pressure reduction in the first 24 hours of acute stroke onset. Neurology 61, 1047–1051 (2003).

    Article  CAS  Google Scholar 

  3. Sandset, E. C. et al. The angiotensin-receptor blocker candesartan for treatment of acute stroke (SCAST): a randomised, placebo-controlled, double-blind trial. Lancet 377, 741–750 (2011).

    Article  CAS  Google Scholar 

  4. Schrader, J. et al. The ACCESS Study: evaluation of Acute Candesartan Cilexetil Therapy in Stroke Survivors. Stroke 34, 1699–1703 (2003).

    Article  Google Scholar 

  5. Potter, J. F. et al. Controlling Hypertension and Hypotension Immediately Post-Stroke (CHIPPS): a randomized, placebo-controlled, double-blind pilot trial. Lancet Neurol. 8, 48–56 (2009).

    Article  CAS  Google Scholar 

  6. Leonardi-Bee, J., Bath, P. M., Phillips, S. J. & Sandercock, P. A. Blood pressure and clinical outcomes in the International Stroke Trial. Stroke 33, 1315–1320 (2002).

    Article  Google Scholar 

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Wityk, R. Are antihypertensives beneficial in acute stroke?. Nat Rev Neurol 7, 367–368 (2011). https://doi.org/10.1038/nrneurol.2011.91

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