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

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dc.contributor.authorKrishnan, Kailash
dc.contributor.authorScutt, Polly
dc.contributor.authorWoodhouse, Lisa
dc.contributor.authorAdami, Alessandro
dc.contributor.authorBecker, Jennifer L.
dc.contributor.authorCala, Lesley A.
dc.contributor.authorCasado, Ana M.
dc.date.accessioned2020-03-26T19:23:27Z
dc.date.available2020-03-26T19:23:27Z
dc.date.issued2016
dc.departmentSelçuk Üniversitesien_US
dc.description.abstractBackground 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 < .01). At 90 days, the primary outcome did not differ between the groups; the adjusted common odds ratio (OR) for worse outcome with continue versus stop drugs was .92 (95% confidence interval, .45-1.89; P = .83). There was no difference between the treatment groups for any secondary outcome measure, or rates of death or serious adverse events. Conclusions: Among patients with acute ICH, immediate continuation of antihypertensive drugs during the first week did not reduce death or major disability in comparison to stopping treatment temporarily.en_US
dc.description.sponsorshipBupa UK Foundation; Medical Research CouncilMedical Research Council UK (MRC) [G0501797]; Agency for Science, Technology and Research (Singapore)Agency for Science Technology & Research (ASTAR); Hypertension Trust (United Kingdom); Queen Elizabeth II Health Sciences Centre Research Fund (Canada); Reichstadt Family (United Kingdom); Scottish Funding Council; Chief Scientist Office SINAPSE Collaboration; National Institute for Health ResearchNational Institute for Health Research (NIHR) [NF-SI-0611-10003]en_US
dc.description.sponsorshipEfficacy of Nitric oxide in Stroke (ENOS) was funded by Bupa UK Foundation and the Medical Research Council (G0501797). Other funders that supported ENOS were the Agency for Science, Technology and Research (Singapore), Hypertension Trust (United Kingdom), Queen Elizabeth II Health Sciences Centre Research Fund (Canada), and Reichstadt Family (United Kingdom). J.M.W. was supported by the Scottish Funding Council and Chief Scientist Office SINAPSE Collaboration (www.sinapse.ac.uk).en_US
dc.identifier.doi10.1016/j.jstrokecerebrovasdis.2016.01.010en_US
dc.identifier.endpage1026en_US
dc.identifier.issn1052-3057en_US
dc.identifier.issn1532-8511en_US
dc.identifier.issue5en_US
dc.identifier.pmid26853137en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage1017en_US
dc.identifier.urihttps://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2016.01.010
dc.identifier.urihttps://hdl.handle.net/20.500.12395/33398
dc.identifier.volume25en_US
dc.identifier.wosWOS:000375144200005en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherELSEVIER SCIENCE BVen_US
dc.relation.ispartofJOURNAL OF STROKE & CEREBROVASCULAR DISEASESen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.selcuk20240510_oaigen_US
dc.subjectAntihypertensive therapyen_US
dc.subjectblood pressureen_US
dc.subjectglyceryl trinitrateen_US
dc.subjectintracerebral hemorrhageen_US
dc.subjectcerebrovascular disordersen_US
dc.subjectrandomized controlled trialen_US
dc.titleContinuing versus Stopping Prestroke Antihypertensive Therapy in Acute Intracerebral Hemorrhage: A Subgroup Analysis of the Efficacy of Nitric Oxide in Stroke Trialen_US
dc.typeArticleen_US

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