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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.”

Loyola University Health System (LUHS) is a member of Trinity Health. Based in the western suburbs of Chicago, LUHS is a quaternary care system with a 61-acre main medical center campus, the 36-acre Gottlieb Memorial Hospital campus and more than 30 primary and specialty care facilities in Cook, Will and DuPage counties. The medical center campus is conveniently located in Maywood, 13 miles west of the Chicago Loop and 8 miles east of Oak Brook, Ill. The heart of the medical center campus is a 559-licensed-bed hospital that houses a Level 1 Trauma Center, a Burn Center and the Ronald McDonald® Children's Hospital of Loyola University Medical Center. Also on campus are the Cardinal Bernardin Cancer Center, Loyola Outpatient Center, Center for Heart & Vascular Medicine and Loyola Oral Health Center as well as the LUC Stritch School of Medicine, the LUC Marcella Niehoff School of Nursing and the Loyola Center for Fitness. Loyola's Gottlieb campus in Melrose Park includes the 255-licensed-bed community hospital, the Professional Office Building housing 150 private practice clinics, the Adult Day Care, the Gottlieb Center for Fitness, Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park.

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Jim Ritter
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