Document Detail

Effect of the Ca antagonist nilvadipine on stroke occurrence or recurrence and extension of asymptomatic cerebral infarction in hypertensive patients with or without history of stroke (PICA Study). 1. Design and results at enrollment.
MedLine Citation:
PMID:  17596689     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We examined the effect of a Ca antagonist (nilvadipine) on the occurrence or recurrence of symptomatic stroke in hypertensive patients with MRI-defined asymptomatic cerebral infarction (ACI), periventricular hyperintensity (PVH), and deep and subcortical white matter hyperintensity (DSWMH), with or without a history of stroke, and evaluated the effect of long-term treatment on the lesions. METHODS: Patients with hypertension and incidental ACI were divided into those with (group B, 235 patients) or without (group A, 181 patients) a history of symptomatic stroke, and were given nilvadipine 4-8 mg/day for 3 years. Primary evaluation points were occurrence of symptomatic ischemic stroke and development or extension of asymptomatic ischemic lesions. RESULTS: Male sex, hyperuricemia, diabetes, maximum diameter of infarction and PVH severity were stronger risk factors for group B. Numbers of cerebral infarctions were 31 +/- 28 (group A) and 42 +/- 32 (group B) at enrollment (p < 0.001). Infarctions were larger and located more frequently on the internal capsule, putamen, thalamus and brainstem in group B. The severity of PVH and DSWMH paralleled the number of cerebral infarctions in both groups. CONCLUSION: The study design and status of asymptomatic ischemic brain lesions in hypertensive subjects at enrollment are presented.
Yukito Shinohara; Hideo Tohgi; Shunsaku Hirai; Akiro Terashi; Yasuo Fukuuchi; Takenori Yamaguchi; Toshio Okudera
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2007-06-27
Journal Detail:
Title:  Cerebrovascular diseases (Basel, Switzerland)     Volume:  24     ISSN:  1015-9770     ISO Abbreviation:  Cerebrovasc. Dis.     Publication Date:  2007  
Date Detail:
Created Date:  2007-08-23     Completed Date:  2007-10-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9100851     Medline TA:  Cerebrovasc Dis     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  202-9     Citation Subset:  IM    
Federation of National Public Service Personnel Mutual Aid Associations, Tachikawa Hospital, Tokyo, Japan.
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MeSH Terms
Aged, 80 and over
Antihypertensive Agents / therapeutic use*
Calcium Channel Blockers / therapeutic use*
Cerebral Infarction / complications*,  drug therapy,  etiology,  pathology
Hypertension / complications,  drug therapy*,  pathology
Magnetic Resonance Imaging
Middle Aged
Nifedipine / analogs & derivatives*,  therapeutic use
Risk Factors
Severity of Illness Index
Stroke / etiology*,  pathology,  prevention & control
Time Factors
Treatment Outcome
Reg. No./Substance:
0/Antihypertensive Agents; 0/Calcium Channel Blockers; 21829-25-4/Nifedipine; 75530-68-6/nilvadipine

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