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No Benefit to Lowering Blood Pressure in Acute Stroke: Study
Date:2/11/2011

By Steven Reinberg
HealthDay Reporter

FRIDAY, Feb. 11 (HealthDay News) -- Giving medication to lower blood pressure in hypertensive stroke patients appears to have no benefit and might even be harmful, says a new study that seems to confirm current treatment guidelines.

"Clinicians should not be prescribing blood-pressure-lowering drugs within the first week of acute stroke in routine practice, but researchers should continue to evaluate the safety and effectiveness of other interventions for blood pressure in acute stroke," said Dr. Graeme J. Hankey, head of the Stroke Unit at Royal Perth Hospital in Australia, who is familiar with the study.

Researchers looked at the effect of the blood pressure-lowering drug candesartan on about 1,000 acute stroke patients. Their findings are published online Feb. 11 in The Lancet to coincide with presentation of the study at the International Stroke Conference in Los Angeles.

When added to the results of 10 previous trials, this study indicates that lowering blood pressure in the first week after acute stroke has no overall benefit on subsequent outcome, said Hankey, author of an accompanying journal editorial.

Doctors have been unsure how to treat high blood pressure in acute stroke patients, and current guidelines recommend leaving it alone.

For the study, a multicenter team led by Dr. Eivind Berge from Oslo University Hospital Ulleval in Norway randomly assigned 2,029 acute stroke patients to take candesartan (Atacand) or a placebo. Candesartan belongs to a family of drugs called angiotensin-receptor blockers.

Over a week, the drug significantly lowered the blood pressure of patients receiving it. However, over six months no difference emerged between the two groups in the risk of death, heart attack or stroke, the researchers found.

Moreover, patients taking the drug tended to have poorer outcomes, compared with patients receiving placeb
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