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Central and cerebral haemodynamic changes after antihypertensive therapy in ischaemic stroke patients: A double-blind randomised trial

Authors
Choi, MH  | Lee, JS  | Lee, SE | Lee, SJ  | Yoon, D  | Park, RW  | Hong, JM
Citation
Scientific reports, 8(1). : 1556-1556, 2018
Journal Title
Scientific reports
ISSN
2045-2322
Abstract
Central and cerebral haemodynamic parameters can vary under similar brachial blood pressure (BP). We aimed to investigate the effects of antihypertensive agents on central and cerebral haemodynamic parameters in hypertensive patients with ischaemic stroke. The Fimasartan, Atenolol, and Valsartan On haemodynamic paRameters (FAVOR) study was conducted in a prospective, double-blinded manner. One hundred five patients were randomly administered atenolol, valsartan, or fimasartan during 12 weeks. We measured brachial, central, cerebral haemodynamic parameters and plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels at baseline and after 12-week. Baseline haemodynamic parameters were balanced among the three groups. Even with similar brachial BP reduction, significantly lower central systolic BP (atenolol: 146.5 +/- 18.8 vs. valsartan: 133.5 +/- 20.7 vs. fimasartan: 133.6 +/- 19.8 mmHg, p = 0.017) and augmentation index values (89.8 +/- 13.2 vs. 80.6 +/- 9.2 vs. 79.2 +/- 11.6%: p = 0.001) were seen in the angiotensin receptor blockers (ARBs) groups. The pulsatility index on transcranial Doppler was significantly reduced in valsartan (p = 0.002) and fimasartan group (p = 0.008). Plasma NT-proBNP level was also significantly decreased in ARB groups, especially for the fimasartan group (37.8 +/- 50.6 vs. 29.2 +/- 36.9 vs.19.2 +/- 27.8 pg/mL: p = 0.006). These findings suggest that short-term ARB administration would be favourable for ischaemic stroke patients with hypertension, permitting effective reduction of central pressure and dampening of cerebral pulsatility.
MeSH

DOI
10.1038/s41598-018-19998-4
PMID
29367614
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Neurology
Journal Papers > School of Medicine / Graduate School of Medicine > Biomedical Informatics
Ajou Authors
박, 래웅  |  윤, 덕용  |  이, 성준  |  이, 진수  |  최, 문희  |  홍, 지만
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