Table of Contents
ISRN Stroke
Volume 2013, Article ID 587954, 9 pages
http://dx.doi.org/10.1155/2013/587954
Clinical Study

Effect of Telmisartan on Cerebral and Systemic Haemodynamics in Patients with Recent Ischaemic Stroke: A Randomised Controlled Trial

1Division of Stroke, University of Nottingham, Clinical Sciences Building, City Hospital Campus, Nottingham NG5 1PB, UK
2Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK
3Division of Academic Radiology, University of Nottingham, Nottingham NG7 2UH, UK

Received 12 March 2013; Accepted 8 April 2013

Academic Editors: A. Ducruet, E. Gonzalez-Toledo, A. Slivka, and J. Wang

Copyright © 2013 Gillian M. Sare et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. J. Leonardi-Bee, P. M. W. Bath, S. J. Phillips, and P. A. G. Sandercock, “Blood pressure and clinical outcomes in the International Stroke Trial,” Stroke, vol. 33, no. 5, pp. 1315–1320, 2002. View at Publisher · View at Google Scholar · View at Scopus
  2. N. Sprigg, L. J. Gray, P. M. W. Bath et al., “Relationship between outcome and baseline blood pressure and other haemodynamic measures in acute ischaemic stroke: data from the TAIST trial,” Journal of Hypertension, vol. 24, no. 7, pp. 1413–1417, 2006. View at Publisher · View at Google Scholar · View at Scopus
  3. G. M. Sare, M. Ali, A. Shuaib, and P. M. W. Bath, “Relationship between hyperacute blood pressure and outcome after ischemic stroke: data from the VISTA collaboration,” Stroke, vol. 40, no. 6, pp. 2098–2103, 2009. View at Publisher · View at Google Scholar · View at Scopus
  4. J. Schrader, S. Lüders, A. Kulschewski et al., “The access study. Evaluation of acute candesartan therapy in stroke survivors,” Stroke, vol. 34, no. 7, pp. 1699–1703, 2003. View at Publisher · View at Google Scholar · View at Scopus
  5. J. F. Potter, T. G. Robinson, G. A. Ford et al., “Controlling hypertension and hypotension immediately post-stroke (CHHIPS): a randomised, placebo-controlled, double-blind pilot trial,” The Lancet Neurology, vol. 8, no. 1, pp. 48–56, 2009. View at Publisher · View at Google Scholar · View at Scopus
  6. C. S. Anderson, Y. Huang, J. G. Wang et al., “Intensive blood pressure reduction in acute cerebral haemorrhage trial (INTERACT): a randomised pilot trial,” The Lancet Neurology, vol. 7, no. 5, pp. 391–399, 2008. View at Publisher · View at Google Scholar · View at Scopus
  7. D. H. Barer, J. M. Cruickshank, S. B. Ebrahim, and J. R. A. Mitchell, “Low dose β blockade in acute stroke ('BEST' trial): an evaluation,” British Medical Journal, vol. 296, no. 6624, pp. 737–741, 1988. View at Google Scholar · View at Scopus
  8. N. G. Wahlgren, D. G. MacMahon, J. de Keyser, B. Indredavik, and T. Ryman, “Intravenous nimodipine west european stroke trial (inwest) of nimodipine in the treatment of acute ischaemic stroke,” Cerebrovascular Diseases, vol. 4, pp. 204–210, 1994. View at Google Scholar
  9. C. M. Geeganage and P. M. W. Bath, “Relationship between therapeutic changes in blood pressure and outcomes in acute stroke: a metaregression,” Hypertension, vol. 54, no. 4, pp. 775–781, 2009. View at Publisher · View at Google Scholar · View at Scopus
  10. E. C. Sandset, P. M. W. Bath, G. Boysen et al., “The angiotensin-receptor blocker candesartan for treatment of acute stroke (SCAST): a randomised, placebo-controlled, double-blind trial,” The Lancet, vol. 377, no. 9767, pp. 741–750, 2011. View at Publisher · View at Google Scholar · View at Scopus
  11. ENOS Trial Investigators, “Glyceryl trinitrate vs. control, and continuing vs. stopping temporarily prior antihypertensive therapy, in acute stroke: rationale and design of the Efficacy of Nitric Oxide in Stroke (ENOS) trial (ISRCTN99414122),” International Journal of Stroke, vol. 1, no. 4, pp. 245–249, 2006. View at Publisher · View at Google Scholar · View at Scopus
  12. C. Fieschi, A. Agnoli, N. Battistini, L. Bozzao, and M. Prencipe, “Derangement of regional cerebral blood flow and of its regulatory mechanisms in acute cerebrovascular lesions,” Neurology, vol. 18, no. 12, pp. 1166–1179, 1968. View at Google Scholar · View at Scopus
  13. G. M. Sare, L. J. Gray, and P. M. W. Bath, “Effect of antihypertensive agents on cerebral blood flow and flow velocity in acute ischaemic stroke: systematic review of controlled studies,” Journal of Hypertension, vol. 26, no. 6, pp. 1058–1064, 2008. View at Publisher · View at Google Scholar · View at Scopus
  14. L. Athanassiou, S. M. Hancock, and R. P. Mahajan, “Doppler estimation of zero flow pressure during changes in downstream pressure in a bench model of a circulation using pulsatile flow,” Anaesthesia, vol. 60, no. 2, pp. 133–138, 2005. View at Publisher · View at Google Scholar · View at Scopus
  15. S. M. Hancock, J. R. Eastwood, and R. P. Mahajan, “Effects of inhaled nitrous oxide 50% on estimated cerebral perfusion pressure and zero flow pressure in healthy volunteers,” Anaesthesia, vol. 60, no. 2, pp. 129–132, 2005. View at Publisher · View at Google Scholar · View at Scopus
  16. S. Yusuf, H. C. Diener, R. L. Sacco et al., “Telmisartan to prevent recurrent stroke and cardiovascular events,” The New England Journal of Medicine, vol. 359, pp. 1225–1237, 2008. View at Google Scholar
  17. H. Yonas, D. Gur, D. Claassen, S. K. Wolfson Jr., and J. Moossy, “Stable xenon-enhanced CT measurement of cerebral blood flow in reversible focal ischemia in baboons,” Journal of Neurosurgery, vol. 73, no. 2, pp. 266–273, 1990. View at Google Scholar · View at Scopus
  18. M. Willmot, A. Ghadami, B. Whysall, W. Clarke, J. Wardlaw, and P. M. W. Bath, “Transdermal glyceryl trinitrate lowers blood pressure and maintains cerebral blood flow in recent stroke,” Hypertension, vol. 47, no. 6, pp. 1209–1215, 2006. View at Publisher · View at Google Scholar · View at Scopus
  19. B. K. Siesjo, “Pathophysiology and treatment of focal cerebral ischemia. Part I: pathophysiology,” Journal of Neurosurgery, vol. 77, no. 2, pp. 169–184, 1992. View at Google Scholar · View at Scopus
  20. J.-C. Baron, “Perfusion thresholds in human cerebral ischemia: historical perspective and therapeutic implications,” Cerebrovascular Diseases, vol. 11, no. 1, pp. 2–8, 2001. View at Google Scholar · View at Scopus
  21. K.-A. Hossmann, “Viability thresholds and the penumbra of focal ischemia,” Annals of Neurology, vol. 36, no. 4, pp. 557–565, 1994. View at Publisher · View at Google Scholar · View at Scopus
  22. C. H. Chen, C. T. Ting, A. Nussbacher et al., “Validation of carotid artery tonometry as a means of estimating augmentation index of ascending aortic pressure,” Hypertension, vol. 27, no. 2, pp. 168–175, 1996. View at Google Scholar · View at Scopus
  23. J. Stangier, C. P. F. Su, P. N. M. van Heiningen et al., “Inhibitory effect of telmisartan on the blood pressure response to angiotensin II challenge,” Journal of Cardiovascular Pharmacology, vol. 38, no. 5, pp. 672–685, 2001. View at Publisher · View at Google Scholar · View at Scopus
  24. K. J. McClellan and A. Markham, “Telmisartan,” Drugs, vol. 56, no. 6, pp. 1039–1044, 1998. View at Publisher · View at Google Scholar · View at Scopus
  25. J. Schrader, S. Lüders, A. Kulschewski et al., “Acute candesartan cilexetil evaluation in stroke survivors (ACCESS Study),” Stroke, vol. 34, no. 7, pp. 1699–1703, 2003. View at Publisher · View at Google Scholar · View at Scopus
  26. W. Dai, A. Funk, T. Herdegen, T. Unger, and J. Culman, “Blockade of Central Angiotensin AT1 receptors improves neurological outcome and reduces expression of AP-1 transcription factors after focal brain ischemia in rats,” Stroke, vol. 30, no. 11, pp. 2391–2399, 1999. View at Google Scholar · View at Scopus
  27. M. Iwai, H. W. Liu, R. Chen et al., “Possible inhibition of focal cerebral ischemia by angiotensin II type 2 receptor stimulation,” Circulation, vol. 110, no. 7, pp. 843–848, 2004. View at Publisher · View at Google Scholar · View at Scopus
  28. H. Kakuta, K. Sudoh, M. Sasamata, and S. Yamagishi, “Telmisartan has the strongest binding affinity to angiotensin II type 1 receptor: comparison with other angiotensin II type 1 receptor blockers,” International Journal of Clinical Pharmacology Research, vol. 25, no. 1, pp. 41–46, 2005. View at Google Scholar · View at Scopus
  29. J. Stangier, C. A. P. F. Su, and W. Roth, “Pharmacokinetics of orally and intravenously administered telmisartan in healthy young and elderly volunteers and in hypertensive patients,” Journal of International Medical Research, vol. 28, no. 4, pp. 149–167, 2000. View at Google Scholar · View at Scopus
  30. H.-C. Diener, R. L. Sacco, S. Yusuf et al., “Effects of aspirin plus extended-release dipyridamole versus clopidogrel and telmisartan on disability and cognitive function after recurrent stroke in patients with ischaemic stroke in the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) trial: a double-blind, active and placebo-controlled study,” The Lancet Neurology, vol. 7, no. 10, pp. 875–884, 2008. View at Publisher · View at Google Scholar · View at Scopus
  31. P. M. W. Bath, R. H. Martin, Y. Palesch et al., “Effect of telmisartan on functional outcome, recurrence, and blood pressure in patients with acute mild ischemic stroke: a PRoFESS subgroup analysis,” Stroke, vol. 40, no. 11, pp. 3541–3546, 2009. View at Publisher · View at Google Scholar · View at Scopus
  32. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group, “Tissue plasminogen activator for acute ischemic stroke,” The New England Journal of Medicine, vol. 333, no. 24, pp. 1581–1587, 1995. View at Publisher · View at Google Scholar · View at Scopus
  33. W. Hacke, M. Kaste, E. Bluhmki et al., “Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke,” The New England Journal of Medicine, vol. 359, no. 13, pp. 1317–1329, 2008. View at Publisher · View at Google Scholar · View at Scopus
  34. D. Thomas, P. M. Bath, K. Lees et al., “Glyceryl trinitrate vs. control, and continuing vs. stopping temporarily prior antihypertensive therapy, in acute stroke: rationale and design of the Efficacy of Nitric Oxide in Stroke (ENOS) trial (ISRCTN99414122),” International Journal of Stroke, vol. 1, no. 4, pp. 245–249, 2006. View at Publisher · View at Google Scholar · View at Scopus