A systematic review and meta-analysis of early diagnosis and treatment of hypertensive stroke under calcium channel blockers

BACKGROUND: A systematic evaluation of the therapeutic effects of calcium channel blockers (CCB) on stroke is carried out to provide clinical evidence for their application. METHODS: A search for randomized controlled trials (RCTs) of CCB in the treatment of stroke patients in the electronic databases of PubMed, Embase, Medline, Spring, and Ovid from their establishment to January 31, 2021 was performed, and the collected studies were then screened for the exclusion criteria. The Cochrane Handbook version 5.0.2 system evaluation writing manual was adopted to evaluate the risk of bias for the included literature, and a meta-analysis using Review Manager 5.3 software was applied. RESULTS: A total of 13 RCTs were included, comprising 1,067 subjects. The meta-analysis showed that the recurrence rate of stroke in patients from the observation group reduced sharply after CCB treatment [mean difference (MD) =0.41, 95% confidence interval (CI): 0.24-0.70, Z=3.31, P=0.0009], the Mini-Mental State Examination (MMSE) score improved markedly (MD =2.82, 95% CI: 1.69-3.95, Z=4.89, P<0.00001), and the Montreal Cognitive Assessment (MoCA) score was obviously increased (MD =6.07, 95% CI: 0.34-11.81, Z=2.08, P=0.04). Moreover, the diastolic blood pressure of the observation group decreased steeply after CCB treatment (MD =-1.11, 95% CI: -2.06-0.15, Z=2.27, and P=0.02). However, the effective rate of clinical treatment did not increase hugely (MD =1.70, 95% CI: 0.50-5.83, Z=0.85, P=0.40), and systolic blood pressure did not drop sharply (MD =-1.24, 95% CI: -2.85-0.37, Z=1.51, P=0.13). DISCUSSION: CCB treatment of stroke effectively prevented stroke recurrence, and showed faster recovery of cognitive function, and better lowering of blood pressure, all of which makes CCBs suitable for the treatment of stroke.