• Int J Stroke · Dec 2016

    Randomized Controlled Trial Multicenter Study

    Effects of early blood pressure reduction on cognitive function in patients with acute ischemic stroke.

    • Xiaoqing Bu, Yonghong Zhang, Lydia A Bazzano, Tan Xu, Libing Guo, Xuemei Wang, Jintao Zhang, Yong Cui, Dong Li, Fengshan Zhang, Zhong Ju, Tian Xu, Chung-Shiuan Chen, Jing Chen, and Jiang He.
    • School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.
    • Int J Stroke. 2016 Dec 1; 11 (9): 1009-1019.

    BackgroundThe effect of early blood pressure reduction on cognitive function in patients with acute ischemic stroke remains unknown.AimWe tested whether antihypertensive treatment would reduce cognitive impairment in patients with acute ischemic stroke.MethodsIn 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.ResultsMean 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).ConclusionsThese 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.© 2016 World Stroke Organization.

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