Antihypertensive drugs for patients with chronic stroke

Abstract

The aim of this survey was to examine the recent trends in the use of antihypertensive drugs for patients with chronic stroke. We studied the age, stroke subtypes, presence of hypertension, type of antihypertensive drugs and blood pressure levels in out-patients with chronic stroke at Kyushu University Hospital and our six satellite hospitals with 17 specialists for stroke. Among 762 patients with chronic stroke, 563 (73.9%) were diagnosed to be hypertensive, and antihypertensive drugs were given in 405 of the hypertensives (71.9%). The average blood pressure was 144 ± 17/82 ± 11 mmHg in the patients receiving antihypertensive drugs (n=405) and 140 ±17/80 ± 10 mmHg in the patients without drug treatment (n=158). The levels of blood pressure observed in the present study suggested that even in patients with drug treatment, hypertension was adequately controlled. Calcium antagonist (Ca antagonist) was most frequently used (58.4%), followed by angiotensin converting enzyme inhibitor (ACEI, 23.9%), β-adrenergic receptor blocker (β-blocker, 16.0%), and diuretics (5.9%). As regards combinations of drugs, 34.8% of the patients were given Ca antagonist alone, followed by the combination of Ca antagonist and ACEI (10.5%), Ca antagonist and fi-blocker (5.9%), ACEI alone (5.7%), β-blocker alone (5.5%), the combination of Ca antagonist, ACEI and fi-blocker (2.3%) and the combination of Ca antagonist, ACEI and diuretics (2.3%). Ca antagonist was more solely and preferably employed in the older patients. Our study revealed that Ca antagonist is the antihypertensive drug most frequently used by stroke specialists. ACEI and β-blocker are next in terms of preferable use.