• Roger M Krzyżewski, Kornelia M Kliś, Borys M Kwinta, Krzysztof Stachura, Karolina Piotrowicz, Tadeusz J Popiela, Maciej J Frączek, Tomasz Grodzicki, and Jerzy Gąsowski.
• Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland. roger.krzyzewski@gmail.com
• Pol. Arch. Med. Wewn. 2024 Feb 28; 134 (2).

IntroductionAneurysmal subarachnoid hemorrhage is a devastating type of stroke, associated with high mortality and morbidity. One of modifiable risk factors of aneurysm rupture is hypertension, however, it is still not clear whether any particular antihypertensive drugs play a significant role in the prevention of aneurysm rupture.ObjectivesWe decided to investigate whether there is any association between acetylsalicylic acid, α-blockers, β‑blockers, angiotensin‑converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, diuretics, statins, and anticoagulants and a risk of intracranial aneurysm rupture.Patients And MethodsWe retrospectively analyzed 334 patients with ruptured and unruptured intracranial aneurysm. Based on logistic regression models, we obtained unadjusted and adjusted odds ratios (ORs) of subarachnoid hemorrhage associated with the use of vasoactive medications and with indices of tortuosity.ResultsWe found that β‑blocker intake was significantly related to higher tortuosity of the cerebral arteries. Also, the intake of β‑blockers (OR, 0.41; 95% CI, 0.21-0.77; P = 0.01) and statins (OR, 0.23; 95% CI, 0.05-0.68; P = 0.01) significantly decreased the risk of aneurysm rupture, a result driven by a decreased rupture risk of anterior circulation aneurysms. No such association was found for the posterior part of the cerebral circulation.ConclusionsAneurysm located in the anterior cerebral circulation might be less likely to rupture if patients receive β‑blockers or statins.

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