title: Effects of candesartan in acute stroke on cognitive function and quality of life: results from the Scandinavian Candesartan Acute Stroke Trial.
abstract: OBJECTIVE
  High blood pressure is common in the acute phase of stroke and is associated with poor outcome. We examined whether blood pressure-lowering treatment with candesartan in the acute phase affects long-term cognitive function and quality of life.
  
  
  METHODS
  Scandinavian Candesartan Acute Stroke Trial was a randomized-controlled and placebo-controlled trial of candesartan in 2029 patients with acute stroke and raised blood pressure. At 6 months, cognitive function was assessed by the Mini Mental State Examination and quality of life by the EuroQol instrument. We used ordinal logistic and multiple linear regression for statistical analysis, adjusting for predefined key variables.
  
  
  RESULTS
  Median Mini Mental State Examination score was 28 in both groups, and there was no significant difference between the distribution of Mini Mental State Examination scores in the 2 groups (common odds ratio, 1.11; 95% confidence interval, 0.91-1.34; P=0.32). Median EuroQol-5D index were 0.74 and 0.78 (P=0.034), and the mean EuroQol-visual analogue scale scores were 66.0 and 67.3 in the candesartan and placebo groups, respectively (P=0.11).
  
  
  CONCLUSIONS
  Candesartan did not improve cognitive function or quality of life. Rather, there were signs of harmful effects. These findings support the conclusion from our previous report that there is no indication for routine blood pressure-lowering treatment with candesartan in the acute phase of stroke.
  
  
  BACKGROUND
  www.clinicaltrials.gov. Unique identifier: NCT00120003.
authors: Department of Internal Medicine, Oslo University Hospital, Oslo, Norway.
authors: Astrid G
authors: AG
authors: Hornslien
authors: Else C
authors: EC
authors: Sandset
authors: Philip M
authors: PM
authors: Bath
authors: Torgeir B
authors: TB
authors: Wyller
authors: Eivind
authors: E
authors: Berge
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000494:pharmacology*; D001562:Benzimidazoles / Q000009:adverse effects* / Q000494:pharmacology*; D001713:Biphenyl Compounds; D003072:Cognition Disorders / Q000188:drug therapy* / Q000209:etiology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011788:Quality of Life; D012537:Scandinavian and Nordic Countries; D020521:Stroke / Q000150:complications / Q000188:drug therapy*; D013777:Tetrazoles / Q000009:adverse effects* / Q000494:pharmacology*; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D013777:Tetrazoles; C081643:candesartan
keywords: Acute stroke; Candesartan; Cognition; Hypertension; Quality of life