BP modulation by class action
| Trial | Stroke type (IS/ICH) | Drug | Time given (hours) | BP effect | CBF effect | Clinical outcome |
|---|---|---|---|---|---|---|
| α2 adrenoreceptor agonist | Increase (rats) | Neutral | ||||
| Lisk et al (1993)24 | IS | Clonidine | <72 | Mean reduction: SBP 13.6, DBP 2.1 mm Hg | ||
| ACEi | Maintain/increase | Neutral | ||||
| CHIPPS 200925 | All | Lisinopril (PO/SL) | <36 (mean 19) | Mean reduction: SBP 14 mm Hg DBP 7 mm Hg | ||
| PIL-FAST 201326 | All | Lisinopril (SL/PO) | <3 | |||
| ARA | Neutral/reduce | Neutral/poor | ||||
| ACCESS 200327 | IS | Candesartan (PO) | <36 (mean 29) | No difference | ||
| PRoFESS 200928 | IS | Telmisartan (PO) | <72 (mean 58) | SBP: 6–7 mm Hg DBP: 2–4 mm Hg | ||
| SCAST 201129 | All | Candesartan (PO) | <30 (mean 18) | Mean difference at 7 days: SBP 5 mm Hg DBP 2 mm Hg | ||
| VENTURE 201530 | IS | Valsartan (PO) | <24 (mean 12) | Mean difference at 7 days: SBP 4 mm Hg DBP 2 mm Hg | ||
| α and β-Blocker | Neutral | Neutral | ||||
| CHIPPS 200925 | All | Labetalol (PO/IV) | <36 (mean 19) | Mean reduction: SBP 7 mm Hg DBP increase 0.6 mm Hg | ||
| β-Blockers | ?Reduce | Poor | ||||
| BEST 198831 | Unknown | Propranolol (PO), atenolol (PO) | <48 | Reduction: 6–9% vs 2% (placebo) | ||
| CCA | Reduce | Poor | ||||
| INWEST 199432 | IS | Nimodipine (IV) 1 mg/hour (low dose), 2 mg/hour (high dose) | <24 | SBP low dose: 6.6%; high dose 11.4%; placebo 2.1% DBP low dose 7.7%; high 14.1%; placebo 1.7%; | ||
| VENUS 200133 | All | Nimodipine (PO) | <6 | No difference | ||
| Systematic review (Horn 2001)34 | IS | Poor | ||||
| Diuretics | Neutral | Neutral | ||||
| Eames et al (2005)35 | IS | Bendroflumethiazide (PO) | <96 | No difference | ||
| Magnesium | Increase | Neutral | ||||
| IMAGES 200436 | IS | Magnesium sulfate IV bolus and infusion | <12 (median 7) | BP difference at 24: 4/3 mm Hg vs placebo | ||
| FAST-MAG 201537 | All | Magnesium sulfate IV bolus and infusion | <2 (median 45 min) | SBP difference at 24: 3 mm Hg | ||
| NO donors | Increase | Neutral ?early effect | ||||
| RIGHT 201338 | All | GTN 5 mg topical patch | <6 (median 55 min) | SBP difference at 2: 18 mm Hg | ||
| ENOS 201439 | All | GTN 5 mg topical patch | <48 (median 26) | Mean reduction at 24: SBP 7 mm Hg; DBP 3 mm Hg | ||
| Pressors | ||||||
| Hillis et al (2003)40 | IS | IV Phenylephrine | <1 week | No data | Increase | Unknown |
| Sprigg et al (2007)41 | IS | PO Amphetamine | 3–30 days | SBP at 90 min increased by 11 mm Hg | Neutral | Neutral/poor (83) |
| Saxena et al (1999)42 | IS | IV DCLHb | <72 | MAP at 2 increased by 21 mm Hg | Poor | |
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.