Blood pressure medications given right after stroke not beneficial, study finds

A major study has found that giving stroke 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 is 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, who were randomly assigned to receive blood pressure medications or to discontinue blood pressure medications. At 14 days or 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 Jose 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 is published in the Feb. 5 issue of the Journal of the American Medical Association. It is titled "Effects of Immediate Blood Pressure Reduction on Death and Major Disability in Patients with Acute Ischemic Stroke: The CATIS Randomized Clinical Trial.