Antihypertensive drugs and inflammation in acute ischemic stroke as a predictor factor of future cardiovascular mortality.
The beneficial effects of antihypertensive drugs in secondary stroke prevention could not be based on their effects on lowering hypertension only.In this prospective study, the status of blood pressure, treatment regimens, new atherothrombotic event, blood sampling for hs-CRP and fibrinogen were asked at initial visit, 6th, and 12th months in 226 patients with atherothrombotic stroke.Eighty-seven percent of patients had an antihypertensive regimen, but hypertension control was achieved in 34.1% of patients.Neither use of six different antihypertensive drug regimens nor the change in blood pressure levels showed any difference on new atherothrombotic events, outcomes or survival rates.On the other hand, the higher levels of hs-CRP at baseline were found to be associated with higher mortality rates (p=0.020).Our findings emphasize the predictive role of inflammation in future cardiovascular mortality in patients with acute ischemic stroke, indicating that inflammatory mediators underlying the atherothrombotic process play a more important role than it is assumed.
Cerrahpaşa Faculty of Medicine, Department of Neurology, Istanbul University, 34098, Istanbul, Turkey, drgulcinbenbir@yahoo.com.
Gulcin
G
Benbir
Birsen
B
Ince
Emre
E
Kumral
Zeki
Z
Ongen
Hakan
H
Kultursay
Lale
L
Tokgozoglu
Ali
A
Oto
Hasan
H
Tuzun
D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007249:Inflammation / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D020521:Stroke / Q000276:immunology / Q000401:mortality* / Q000517:prevention & control
D000959:Antihypertensive Agents; D005340:Fibrinogen; D002097:C-Reactive Protein
Can J Cardiol. 2004 Jan;20(1):41-54
14968142
Lancet. 1997 Sep 13;350(9080):757-64
9297994
BMJ. 2003 Jun 28;326(7404):1427
12829555
Acta Neurol Belg. 2005 Jun;105(2):73-80
16076060
Stroke. 1999 May;30(5):981-5
10229731
Lancet. 2000 Dec 9;356(9246):1955-64
11130523
Hypertension. 2003 Dec;42(6):1117-23
14597640
N Engl J Med. 2000 Jan 20;342(3):145-53
10639539
Am J Hypertens. 2003 Jun;16(6):429-33
12799089
Climacteric. 2007 Feb;10 Suppl 1:32-41
17364596
Stroke. 2004 Jul;35(7):1625-30
15155971
Lancet. 2001 Sep 29;358(9287):1033-41
11589932
Md State Med J. 1965 Feb;14:61-5
14258950
J Hypertens. 2007 Jul;25(7):1491-8
17563573
J Hypertens Suppl. 2006 Mar;24(1):S115-21
16601564
Basic Res Cardiol. 1998;93 Suppl 2:69-78
9833167
Stroke. 1988 Dec;19(12):1497-500
3201508
Lancet. 2002 Mar 23;359(9311):995-1003
11937178
J Am Soc Hypertens. 2009 Jul-Aug;3(4):260-6
20161163
Blood Press. 1992 Aug;1(2):113-9
1366259
J Hypertens. 2001 May;19(5):857-61
11393667
Hypertension. 2003 Dec;42(6):1206-52
14656957
Chin Med J (Engl). 1995 Sep;108(9):710-7
8575241
JAMA. 2003 May 21;289(19):2560-72
12748199
Stroke. 2000 Feb;31(2):469-75
10657424
Int Disabil Stud. 1988;10(2):64-7
3042746
Am J Hypertens. 2007 Mar;20(3):233-41
17324732
Stroke. 2005 Sep;36(9):1944-7
16051895
Stroke. 2005 Jun;36(6):1316-29
15879341
Stroke. 2005 Jun;36(6):1218-26
15879332
Circulation. 2003 Jul 15;108(2):166-70
12821545
Stroke. 2003 Jul;34(7):1699-703
12817109
Arch Intern Med. 2001 Jul 9;161(13):1621-8
11434794