Lowering BP shows no benefit in acute stroke

ROUTINE blood pressure (BP) lowering following acute stroke does not offer added protection  against further vascular events, according to results from a multi-centre trial involving 2000 stroke patients.

For the study, patients with acute ischaemic or haemorrhagic stroke and hypertension who were randomised to receive an angiotensin receptor blocker showed no improvement in rates of vascular death, myocardial infarction or stroke compared with those taking placebo.

The trial carried out in nine European countries, supported by an unrestricted grant from candesartan manufacturer AstraZeneca, showed BP was significantly lower in patients taking up to 16 mg of candesartan versus placebo after six months. 

However, side-effects in candesartan patients included 1% developing hypotension (vs <1% in placebo patients) and 2% experiencing renal failure (vs 1%).

Although Professor Graeme Hankey, neurologist at Royal Perth Hospital