Blood Pressure in Acute Stroke Collaboration "BASC"

Recruiting

Phase N/A Results

Results

Phase I (N = 218): Oral calcium channel blockers (CCB's) effected a dose-dependent reduction in systolic (SBP) and diastolic (DBP) blood pressure within 48 hours of administration (SBP reduction: 10.9 mmHg, 95% CI 2.0 - 19.7; DBP reduction: 9.5 mmHg, 95% CI 4.0 - 15.1). Oral CCB's also tended to reduce heart rate by an average of 4.7 bpm (95% CI 0.1 - 9.2) within 48 hours. Angiotensin-converting enzyme (ACE) inhibitors also lowered blood pressure within 24 hours (SBP reduction: 15.0 mmHg, 95% CI -0.6 - 30.6; DBP reduction: 11.8 mmHg, 95% CI 4.2 - 19.4). Glyceryl trinitrate did not significantly reduce blood pressure at 24 hours. No drug was shown to significantly affect patient outcome. Phase II (N = 5368): CCB's in any form significantly reduced blood pressure-- oral CCB's reduced SBP by 3.2 and DBP by 2.1 mmHg (95% CI 1.3 - 5.0, 95% CI 1.0 - 3.0, respectively), while intravenous CCB's reduced SBP by 8.2 and DBP by 6.7 mmHg (95% CI 3.8 - 12.6, 95% CI 4.3 - 9.2). Beta blockers significantly reduced DBP, but not SBP (SBP reduction: -5.0 mmHg, 95% CI -0.4 - 10.2; DBP reduction: 4.5 mmHg, 95% CI 1.15 - 7.8). ACE inhibitors and prostacyclin non-significantly reduced blood pressure, while magnesium, naftidrofuryl and piracetam exerted no significant effect on blood pressure. CCB's reduced heart rate by 2.8 bpm (95% CI 1.7 - 3.9), beta-blockers reduced heart rate by 9.3 bpm (95% CI 6.6 - 12.0), while prostacyclin increased heart rate by 5.6 bpm (95% CI 0.8 - 10.4). None of the drugs significantly improved outcome. Beta-blockers and streptokinase significantly increased the early case fatality (odds ratio 1.77, 95%CI 1.05 to 3.00; odds ratio 2.27, 95% CI 1.4 - 3.67, respectively). Phase III (N = 4,056). No data available yet.