title: Hypertensive patients using thiazide diuretics as primary stroke prevention make better functional outcome after ischemic stroke.
abstract: BACKGROUND
  Thiazides have been used for the control of blood pressure and primary prevention of ischemic stroke. No previous studies have assessed the influence of thiazides on functional prognosis after ischemic stroke.
  
  
  METHODS
  Demographics, prestroke conditions, poststroke National Institutes of Health Stroke Scale score, and clinical and laboratory parameters were prospectively registered in 216 Taiwanese patients. One hundred forty patients who completed follow-up 3 months after experiencing ischemic stroke were assessed with the modified Rankin scale as functional prognoses.
  
  
  RESULTS
  Twenty-one patients used thiazide to control hypertension before experiencing ischemic stroke. No differences of stroke subtypes and comorbidities before stroke were observed between the 2 groups. The emergency department National Institutes of Health Stroke Scale was lesser among thiazide users (4 [2-7] versus 6 [4-16], P = .02). Among 140 patients who completed follow-up in 90 days, thiazide users had more favorable functional status (modified Rankin scale ≤2: 42.4% versus 26.9%, P = .02, odds ratio 3.34, 95%, confidence interval .130-.862).
  
  
  CONCLUSIONS
  Hypertensive patients treated with thiazides long term had a lesser severity of stroke and better functional outcomes after ischemic stroke.
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi and Chang Gung University College of Medicine, Puzi City, Chiayi County, Taiwan (R.O.C.).
authors.forename: Hong-Mo
authors.initials: HM
authors.lastname: Shih
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi and Chang Gung University College of Medicine, Puzi City, Chiayi County, Taiwan (R.O.C.).
authors.forename: Wei Chun
authors.initials: WC
authors.lastname: Lin
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi and Chang Gung University College of Medicine, Puzi City, Chiayi County, Taiwan (R.O.C.).
authors.forename: Cheng-Hsien
authors.initials: CH
authors.lastname: Wang
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi and Chang Gung University College of Medicine, Puzi City, Chiayi County, Taiwan (R.O.C.). Electronic address: a3456711@ms65.hinet.net.
authors.forename: Leng-Chieh
authors.initials: LC
authors.lastname: Lin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000503:physiopathology*; D004232:Diuretics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention; D011379:Prognosis; D011446:Prospective Studies; D020521:Stroke / Q000503:physiopathology* / Q000517:prevention & control*; D049971:Thiazides / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D004232:Diuretics; D049971:Thiazides
keywords: Thiazide-diuretics; functional prognosis; hypertension; ischemic stroke; stroke in evolution; stroke primary prevention