Anti-adrenergic medications and edema development after intracerebral hemorrhage.
BACKGROUND
Use of antihypertensive medications is common after intracerebral hemorrhage (ICH). Medications that block adrenergic activation (e.g., beta-blockers and the alpha(2)-agonist, clonidine) may reduce the inflammatory response and therefore have secondary benefit after ICH.


METHODS
The patients with acute ICH enrolled in the placebo arm of the CHANT trial were included. Univariate and multivariate analyses were undertaken for factors associated with blood pressure medication use, edema at 72 h, and clinical outcome at 90 days.


RESULTS
Of the 303 patients, 87.8% received some antihypertensive treatment during the first 72 h of hospitalization. Edema volume on neuroimaging at 72 h was independently associated with clinical outcome. Use of anti-adrenergic medications was associated with less edema after controlling for hemorrhage volume and blood pressure.


CONCLUSIONS
Antihypertensive medications that antagonize the sympathetic nervous system may reduce perihematomal edema after ICH.
Department of Neurology, University of Connecticut Health Center, 263 Farmington Avenue, MC 3401, Farmington, CT 06030, USA. sansing@uchc.edu
L H
LH
Sansing
S R
SR
Messe
B L
BL
Cucchiara
P D
PD
Lyden
S E
SE
Kasner
D058647:Adrenergic alpha-2 Receptor Agonists / Q000627:therapeutic use*; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D000975:Antioxidants / Q000627:therapeutic use*; D001557:Benzenesulfonates / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D001929:Brain Edema / Q000517:prevention & control*; D002543:Cerebral Hemorrhage / Q000188:drug therapy*; D003000:Clonidine / Q000627:therapeutic use*; D015331:Cohort Studies; D003422:Critical Care / Q000379:methods*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D016896:Treatment Outcome
D058647:Adrenergic alpha-2 Receptor Agonists; D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D000975:Antioxidants; D001557:Benzenesulfonates; D016166:Free Radical Scavengers; C120851:disufenton sodium; D003000:Clonidine
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