Table 1

BP modulation by class action

TrialStroke type (IS/ICH)DrugTime given (hours)BP effectCBF effectClinical outcome
α2 adrenoreceptor agonistIncrease (rats)Neutral
 Lisk et al (1993)24ISClonidine<72Mean reduction: SBP 13.6, DBP 2.1 mm Hg
 CHIPPS 200925AllLisinopril (PO/SL)<36 (mean 19)Mean reduction: SBP 14 mm Hg
DBP 7 mm Hg
 PIL-FAST 201326AllLisinopril (SL/PO)<3
 ACCESS 200327ISCandesartan (PO)<36 (mean 29)No difference
 PRoFESS 200928ISTelmisartan (PO)<72 (mean 58)SBP: 6–7 mm Hg
DBP: 2–4 mm Hg
 SCAST 201129AllCandesartan (PO)<30 (mean 18)Mean difference at 7 days: SBP 5 mm Hg
DBP 2 mm Hg
 VENTURE 201530ISValsartan (PO)<24 (mean 12)Mean difference at 7 days: SBP 4 mm Hg
DBP 2 mm Hg
α and β-BlockerNeutralNeutral
 CHIPPS 200925AllLabetalol (PO/IV)<36 (mean 19)Mean reduction: SBP 7 mm Hg
DBP increase 0.6 mm Hg
 BEST 198831UnknownPropranolol (PO), atenolol (PO)<48Reduction: 6–9% vs 2% (placebo)
 INWEST 199432ISNimodipine (IV) 1 mg/hour (low dose), 2 mg/hour (high dose)<24SBP low dose: 6.6%; high dose 11.4%; placebo 2.1%
DBP low dose 7.7%; high 14.1%; placebo 1.7%;
 VENUS 200133AllNimodipine (PO)<6No difference
 Systematic review (Horn 2001)34ISPoor
 Eames et al (2005)35ISBendroflumethiazide (PO)<96No difference
 IMAGES 200436ISMagnesium sulfate IV bolus and infusion<12 (median 7)BP difference at 24: 4/3 mm Hg vs placebo
 FAST-MAG 201537AllMagnesium sulfate IV bolus and infusion<2 (median 45 min)SBP difference at 24: 3 mm Hg
NO donorsIncreaseNeutral ?early effect
 RIGHT 201338AllGTN 5 mg topical patch<6 (median 55 min)SBP difference at 2: 18 mm Hg
 ENOS 201439AllGTN 5 mg topical patch<48 (median 26)Mean reduction at 24: SBP 7 mm Hg; DBP 3 mm Hg
 Hillis et al (2003)40ISIV Phenylephrine<1 weekNo dataIncreaseUnknown
 Sprigg et al (2007)41ISPO Amphetamine3–30 daysSBP at 90 min increased by 11 mm HgNeutralNeutral/poor (83)
 Saxena et al (1999)42ISIV DCLHb<72MAP at 2 increased by 21 mm HgPoor
  • ACEi, ACE inhibitors inhibitors; ARA, angiotensin receptor antagonists; BP, blood pressure; CBF, cerebral blood flow; CCA, calcium channel antagonists; DBP, diastolic blood pressure; DCLHb, diaspirin cross-linked haemoglobin; GTN, glyceryl trinitrate; ICH, intracerebral haemorrhage; IS, ischaemic stroke; iv, intravenous; po, orally; NO, nitric oxide; SBP, systolic blood pressure.