Wednesday, February 19, 2014

Giving blood pressure medications right after stroke not beneficial, study finds

MAYWOOD, Ill. – A major study has found that giving patients medications to lower their blood pressure during the first 48 hours after a stroke does not reduce the likelihood of death or major disability.

The study was published in the Journal of the American Medical Association.
At least 25 percent of the population has high blood pressure, which greatly increases the risk of stroke. Lowering blood pressure has been shown to reduce the risk of stroke. The study investigated whether there also would be a benefit to lowering blood pressure immediately after a stroke.

The study included more than 4,000 stroke patients in 26 hospitals across China, whom were randomly assigned to receive or discontinue blood pressure medications. At 14 days or upon hospital discharge, there were no statistically significant differences between the groups in mortality or disability.

Blood pressure often is elevated following a stroke.

“But in most cases, treatment is unnecessary because the blood pressure declines naturally over time, and lowering blood pressure may be contraindicated,” said stroke specialist José Biller, MD, chair of the Department of Neurology of Loyola University Medical Center. “It is important not to overtreat and cause low blood pressure because the most important objective is to maintain adequate blood flow to the brain."

Biller was a member of the study’s Data and Safety Monitoring Board. Paul K. Whelton, MD, former president and CEO of Loyola University Health System, was chair of the monitoring board.

First author of the study is Jiang He, MD, PhD, of Tulane University School of Public Health and Tropical Medicine.

The study is called the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS). It involved patients who had suffered ischemic strokes, which account for about 85 percent of all strokes. Such strokes are caused by blood clots that block blood flow to a part of the brain.

The study was published in the Feb. 5 issue of the Journal of the American Medical Association with the title “Effects of Immediate Blood Pressure Reduction on Death and Major Disability in Patients with Acute Ischemic Stroke: The CATIS Randomized Clinical Trial.”

About Loyola University Health System

Loyola University Health System (LUHS) is a member of Trinity Health. Based in the western suburbs of Chicago, LUHS is a quaternary care system that includes Loyola University Medical Center (LUMC), located on a 61-acre campus in Maywood, Gottlieb Memorial Hospital (GMH), on a 36-acre campus in Melrose Park, and convenient locations offering primary and specialty care services throughout Cook, Will and DuPage counties. At the heart of LUMC is a 547-licensed-bed hospital that houses the Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, a burn center, a children's hospital, Loyola Outpatient Center, and Loyola Oral Health Center. The campus also is home to Loyola University Chicago Stritch School of Medicine, Loyola University Chicago Marcella Niehoff School of Nursing and the Loyola Center for Fitness. The GMH campus includes a 254-licensed-bed community hospital, a Professional Office Building with 150 private practice clinics, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park.

Trinity Health is one of the largest multi-institutional Catholic health care delivery systems in the nation. It serves people and communities in 22 states from coast to coast with 93 hospitals, and 120 continuing care locations — including home care, hospice, PACE and senior living facilities — that provide nearly 2.5 million visits annually.