title: Effects of early blood pressure reduction on cognitive function in patients with acute ischemic stroke.
abstract: The effect of early blood pressure reduction on cognitive function in patients with acute ischemic stroke remains unknown.
  
  
  
  We tested whether antihypertensive treatment would reduce cognitive impairment in patients with acute ischemic stroke.
  
  
  
  In the China Antihypertensive Trial in Acute Ischemic Stroke, patients with elevated blood pressure were randomly assigned to receive antihypertensive treatment or to discontinue all hypertensive medications within 48 h of onset. Cognitive function was measured by the Mini-Mental State Examination and Montreal Cognitive Assessment at 3 months after randomization in a subsample of 638 participants.
  
  
  
  Mean systolic blood pressure was reduced by 21.5 mmHg in the antihypertensive treatment group and 13.9 mmHg in the control group within 24 h after randomization (P < 0.001). Mean systolic blood pressure was 134.9 mmHg in the antihypertensive treatment group and 141.6 mmHg in the control group at day 14 after randomization (P < 0.001). Median Mini-Mental State Examination score was 26 and Montreal Cognitive Assessment score was 22 in both the antihypertensive treatment and control groups at 3 months. An Mini-Mental State Examination < 24 was present in 30.9% of patients in the antihypertensive treatment group compared with 29.7% in the control group (odds ratio = 1.06; 95% confidence interval 0.75-1.48; P = 0.75). Likewise, proportions of patients with Montreal Cognitive Assessment < 26 were similar between the antihypertensive treatment (70.6%) and control (70.7%) groups (odds ratio = 0.99; 95% confidence interval 0.70-1.40; P = 0.96).
  
  
  
  These data indicated that early blood pressure reduction with antihypertensive medication in patients with acute ischemic stroke had no effect on cognitive impairment at 3 months.
authors.affiliation: School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.|Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, USA.
authors.forename: Xiaoqing
authors.initials: X
authors.lastname: Bu
authors.affiliation: School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.
authors.forename: Yonghong
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, USA.
authors.forename: Lydia A
authors.initials: LA
authors.lastname: Bazzano
authors.affiliation: School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.
authors.forename: Tan
authors.initials: T
authors.lastname: Xu
authors.affiliation: Department of Neurology, Siping Central Hospital, Jilin, China.
authors.forename: Libing
authors.initials: L
authors.lastname: Guo
authors.affiliation: Department of Neurology, Jilin Central Hospital, Jilin, China.
authors.forename: Xuemei
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Neurology, The 88th Hospital of PLA, Shandong, China.
authors.forename: Jintao
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Neurology, General Hospital of First Automobile Works, Jilin, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Cui
authors.affiliation: Department of Neurology, Feicheng City People's Hospital, Shandong, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Li
authors.affiliation: Department of Neurology, Tongliao Municipal Hospital, Inner Mongolia, China.
authors.forename: Fengshan
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Kerqin District First People's Hospital of Tongliao City, Inner Mongolia, China.
authors.forename: Zhong
authors.initials: Z
authors.lastname: Ju
authors.affiliation: School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.|Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, USA.
authors.forename: Tian
authors.initials: T
authors.lastname: Xu
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, USA.
authors.forename: Chung-Shiuan
authors.initials: CS
authors.lastname: Chen
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, USA.|Department of Medicine, Tulane University School of Medicine, New Orleans, USA.
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.affiliation: School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China jhe@tulane.edu.|Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, USA.|Department of Medicine, Tulane University School of Medicine, New Orleans, USA.
authors.forename: Jiang
authors.initials: J
authors.lastname: He
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D002545:Brain Ischemia / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D002681:China; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D016037:Single-Blind Method; D020521:Stroke / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: Acute ischemic stroke; antihypertensive therapy; clinical trial; cognitive functions