| Effect of telmisartan on functional outcome, recurrence, and blood pressure in patients with acute mild ischemic stroke: a PRoFESS subgroup analysis. | |
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MedLine Citation:
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PMID: 19797187 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: High blood pressure (BP) is common in acute ischemic stroke and associated independently with a poor functional outcome. However, the management of BP acutely remains unclear because no large trials have been completed. METHODS: The factorial PRoFESS secondary stroke prevention trial assessed BP-lowering and antiplatelet strategies in 20 332 patients; 1360 were enrolled within 72 hours of ischemic stroke, with telmisartan (angiotensin receptor antagonist, 80 mg/d, n=647) vs placebo (n=713). For this nonprespecified subgroup analysis, the primary outcome was functional outcome at 30 days; secondary outcomes included death, recurrence, and hemodynamic measures at up to 90 days. Analyses were adjusted for baseline prognostic variables and antiplatelet assignment. RESULTS: Patients were representative of the whole trial (age 67 years, male 65%, baseline BP 147/84 mm Hg, small artery disease 60%, NIHSS 3) and baseline variables were similar between treatment groups. The mean time from stroke to recruitment was 58 hours. Combined death or dependency (modified Rankin scale: OR, 1.03; 95% CI, 0.84-1.26; P=0.81; death: OR, 1.05; 95% CI, 0.27-4.04; and stroke recurrence: OR, 1.40; 95% CI, 0.68-2.89; P=0.36) did not differ between the treatment groups. In comparison with placebo, telmisartan lowered BP (141/82 vs 135/78 mm Hg, difference 6 to 7 mm Hg and 2 to 4 mm Hg; P<0.001), pulse pressure (3 to 4 mm Hg; P<0.002), and rate-pressure product (466 mm Hg.bpm; P=0.0004). CONCLUSIONS: Treatment with telmisartan in 1360 patients with acute mild ischemic stroke and mildly elevated BP appeared to be safe with no excess in adverse events, was not associated with a significant effect on functional dependency, death, or recurrence, and modestly lowered BP. |
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Authors:
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Philip M W Bath; Reneé H Martin; Yuko Palesch; Daniel Cotton; Salim Yusuf; Ralph Sacco; Hans-Christoph Diener; Danilo Toni; Conrado Estol; Robin Roberts; |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2009-09-24 |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: 40 ISSN: 1524-4628 ISO Abbreviation: Stroke Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-10-27 Completed Date: 2009-11-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: United States |
Other Details:
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Languages: eng Pagination: 3541-6 Citation Subset: IM |
Affiliation:
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Stroke Trials Unit, University of Nottingham, City Hospital campus, Nottingham NG5 1PB, UK. philip.bath@nottingham.ac.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Benzimidazoles / therapeutic use* Benzoates / therapeutic use* Blood Pressure / drug effects, physiology Brain Ischemia / drug therapy*, physiopathology, prevention & control Female Follow-Up Studies Humans Hypertension / drug therapy*, physiopathology, prevention & control Male Middle Aged Recurrence / prevention & control Stroke / drug therapy*, physiopathology, prevention & control |
| Chemical | |
Reg. No./Substance:
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0/Benzimidazoles; 0/Benzoates; 144701-48-4/telmisartan |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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