Single-drug antihypertensive therapy in acute cerebral infarction reduced the 6-month mortality/disability ratio compared to control (32.1% vs. 45.0%, p=0.018).
RCT
Does single-drug antihypertensive therapy improve clinical and functional outcomes in patients in the acute stage of cerebral infarction?
Single-drug antihypertensive therapy in the acute stage of cerebral infarction may improve 6-month functional outcomes and reduce recurrent cardiovascular events without worsening the initial condition.
Absolute Event Rate: 32.1% vs 45%
p-value: p=0.018
BACKGROUND: This study investigated whether patients in the acute stage of cerebral infarction (ACI) might benefit from single-drug antihypertensive therapy (AT) without the use of preset target levels. METHODS: month after onset, significant dependent-survival status (SDS, Barthel Index ≤ 60), mortality/disability ratio (modified Rankin Scale ≥ 3), and recurrence rate of cardio-cerebral vascular events (RR-CVE). RESULTS: The National Institutes of Health Stroke Scale (NIHSS) score was 8.39 ± 3.21 vs. 8.16 ± 3.27 in the AT and C groups on entry to the study. On day 14, there were no significant differences in mortality (2.5% vs. 3.1%, p = 0.9994), SDS (50.0% vs. 49.0%, p = 0.864), and mortality/disability ratio (61.3% vs. 66.3%, p = 0.352) between the two groups, however the RR-CVE in the AT group was lower than in group C (4.4% vs. 11.9%, p = 0.014). In month 6, there were no significant difference in mortality rate between the two groups (3.1% vs. 3.8%, p = 0.767), however the SDS (23.4% vs. 34.4%, p = 0.033), mortality/disability ratio (32.1% vs. 45.0%, p = 0.018), and RR-CVE in group AT were lower than in group C (10.7% vs. 19.4%, p = 0.030). CONCLUSIONS: Appropriate AT for patients with ACI does not worsen the disease condition and may improve the prognosis for the patients with moderate or mild stroke severity.
Li et al. (2018) conducted an RCT in Acute stage of cerebral infarction (ACI). Single-drug antihypertensive therapy vs. Control was evaluated on Mortality/disability ratio (modified Rankin Scale ≥ 3) at 6 months (p=0.018). Single-drug antihypertensive therapy in acute cerebral infarction reduced the 6-month mortality/disability ratio compared to control (32.1% vs. 45.0%, p=0.018).