Treating for hypertension may reduce mortality after a stroke

International Stroke Conference Late-Breaking News:

NEW ORLEANS, Feb. 22 — Stroke patients who were treated for high blood pressure – which is common after acute stroke – had lower mortality after three months than patients who received a placebo, according to late-breaking science results reported at the American Stroke Association’s International Stroke Conference 2008.

Elevated blood pressure is common following stroke and is linked with a poor prognosis.

In the United Kingdom’s Control of Hypertension and Hypotension Immediately Post-Stroke (CHHIPS) pilot trial, researchers randomized 179 patients who had suffered ischemic or hemorrhagic strokes within the previous 36 hours and who also had hypertension defined as systolic blood pressure greater than 160 millimeters of mercury (mm Hg).

Patients received doses of either the antihypertensive drugs lisinopril or labetalol or a placebo at increasing doses for 14 days.  The patients were similar across the three groups with respects to age, baseline blood pressure, stroke type, time to treatment, NIHSS (National Institutes of Health Stroke Scale) score and prevalence of dysphagia – difficulty swallowing.

Patients who received an active treatment had greater declines in systolic blood pressure during the first 24 hours compared to those who received a placebo.  After two weeks, blood pressure declines were significantly greater in patients on active treatment than in the placebo group (31 mmHg vs. 24 mmHg). 

Three months after treatment began, the active treatment group had a lower mortality compared to the placebo group.  Those in the placebo group were 2.2 times more likely to die, said lead researcher, John F. Potter, D.M., of the University of East Anglia in the United Kingdom.

Potter concluded that both lisinopril and labetalol significantly lowered blood pressure compared to placebo without causing serious adverse effects or increasing early stroke severity.  They may also reduce stroke deaths at three months, but a larger, definitive study is needed to confirm this.

The study is supported by a National Health Service Research and Development Health Technology Assessment Programme Grant.

Disclosures: None.

Statements and conclusions of abstract authors that are presented at American Heart Association/American Stroke Association scientific meetings are solely those of the abstract authors and do not necessarily reflect association policy or position.  The associations make no representation or warranty as to their accuracy or reliability.

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NR08-1024 (ISC08/LB2/Potter)

Note: This abstract will be presented at 11:40 a.m. CST, Fri., Feb. 22, 2008.