Continuing versus Stopping Prestroke Antihypertensive Therapy in Acute Intracerebral Hemorrhage: A Subgroup Analysis of the Efficacy of Nitric Oxide in Stroke Trial

Kailash Krishnan, Polly Scutt, Lisa Woodhouse, Alessandro Adami, Jennifer L. Becker, Lesley A. Cala, Ana M. Casado, Christopher Chen, Robert A. Dineen, John Gommans, Panos Koumellis, Hanna Christensen, Ronan Collins, Anna Czlonkowska, Kennedy R. Lees, George Ntaios, Serefnur Ozturk, Stephen J. Phillips, Nikola Sprigg, Szabolcs SzatmariJoanna M. Wardlaw, Philip M. Bath*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background and purpose More than 50% of patients with acute intracerebral hemorrhage (ICH) are taking antihypertensive drugs before ictus. Although antihypertensive therapy should be given long term for secondary prevention, whether to continue or stop such treatment during the acute phase of ICH remains unclear, a question that was addressed in the Efficacy of Nitric Oxide in Stroke (ENOS) trial. Methods ENOS was an international multicenter, prospective, randomized, blinded endpoint trial. Among 629 patients with ICH and systolic blood pressure between 140 and 220 mmHg, 246 patients who were taking antihypertensive drugs were assigned to continue (n = 119) or to stop (n = 127) taking drugs temporarily for 7 days. The primary outcome was the modified Rankin Score at 90 days. Secondary outcomes included death, length of stay in hospital, discharge destination, activities of daily living, mood, cognition, and quality of life. Results Blood pressure level (baseline 171/92 mmHg) fell in both groups but was significantly lower at 7 days in those patients assigned to continue antihypertensive drugs (difference 9.4/3.5 mmHg, P

Original languageEnglish
Pages (from-to)1017-1026
Number of pages10
JournalJournal of Stroke and Cerebrovascular Diseases
Volume25
Issue number5
Early online date4 Feb 2016
DOIs
Publication statusPublished - 1 May 2016

Keywords

  • Antihypertensive therapy
  • blood pressure
  • cerebrovascular disorders
  • glyceryl trinitrate
  • intracerebral hemorrhage
  • randomized controlled trial

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