title: Effects of high-dose paracetamol on blood pressure in acute stroke.
abstract: BACKGROUND
  Early administration of paracetamol may improve outcome of patients with acute stroke and a baseline body temperature of 37°C or above by lowering body temperature and preventing fever. Besides its antipyretic effects, paracetamol may affect blood pressure through cyclooxygenase-2 inhibition. We therefore aimed to assess the effect of high-dose paracetamol on blood pressure in patients with acute stroke.
  
  
  METHODS
  We analyzed data of 540 patients admitted within 24 h of stroke onset who were randomized to treatment with either paracetamol (6 g daily) or placebo. Blood pressures were measured at 12, 24, and 48 h from the start of treatment. Changes in blood pressure from baseline in the two treatment groups and corresponding 95% confidence intervals (CI) were calculated with linear regression analysis. Adjustments for potential confounders were made with a multiple linear regression model.
  
  
  RESULTS
  Treatment with high-dose paracetamol was associated with a significant reduction in systolic blood pressure of 4.5 mm Hg (95% CI 0.6-8.5) at 12 h from the start of treatment. This effect was no longer present after 24 and 48 h.
  
  
  CONCLUSIONS
  High-dose paracetamol reduces not only body temperature but also systolic blood pressure in the first 12 h after start of treatment. Both effects may improve functional outcome after stroke, but this needs further study.
authors.affiliation: Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands. m.denhertog@erasmusmc.nl
authors.forename: H M
authors.initials: HM
authors.lastname: den Hertog
authors.forename: H B
authors.initials: HB
authors.lastname: van der Worp
authors.forename: H M A
authors.initials: HM
authors.lastname: van Gemert
authors.forename: J
authors.initials: J
authors.lastname: van Gijn
authors.forename: P J
authors.initials: PJ
authors.lastname: Koudstaal
authors.forename: D W J
authors.initials: DW
authors.lastname: Dippel
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage*; D000368:Aged; D000369:Aged, 80 and over; D058633:Antipyretics; D001794:Blood Pressure / Q000187:drug effects*; D001795:Blood Pressure Determination; D001831:Body Temperature / Q000187:drug effects*; D005260:Female; D005334:Fever / Q000150:complications / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology*; D016896:Treatment Outcome
chemical_list: D058633:Antipyretics; D000082:Acetaminophen