BP medication does not benefit stroke patients

A new study published in The Lancet found that medication for lowering blood pressure in hypertensive stroke patients might be harmful and has little benefit.

Researchers at Oslo University Hospital Ulleval in Norway and several other health facilities administered the angiotensin-receptor blocker candesartan to 1,017 patients with acute stroke and systolic blood pressure of 140 mm Hg or higher with 30 hours of onset. In addition, 1,012 patients were given a placebo.

During the 7-day treatment period, researchers found that blood pressures were significantly lower in patients allocated candesartan than in those taking the placebo.

However, after 6 months of follow-up, the researchers found a greater risk of poor outcomes in the candesartan group. “There was no indication that careful blood-pressure-lowering treatment with the angiotensin-receptor blocker candesartan is beneficial in patients with acute stroke and raised blood pressure. If anything, the evidence suggested a harmful effect,” the researchers wrote in The Lancet.

Eighteen patients taking candesartan suffered kidney failure, compared to 13 patients receiving the placebo, and 9 patients on candesartan had symptoms associated with low blood pressure, while 5 patients taking the placebo had low blood pressure.

The researchers found that between candesartan and the placebo, the observed effects were similar for secondary end points, including death from any cause, vascular death, ischemic stroke, hemorrhagic stroke, myocardial infarction, stroke progression, symptomatic hypotension, and renal failure.