Document Detail

Protective effects of beta-blockers in cerebrovascular disease.
MedLine Citation:
PMID:  17296916     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Because activated sympathetic tone is associated with poorer outcome after stroke, we investigated whether beta-blocker treatment was associated with lesser stroke severity and improved outcome. METHOD: We prospectively studied 111 patients with stroke. Stroke severity on presentation gauged by Canadian Neurologic Scale (CanNS) and medication use verified from medical records. Power spectral analysis of heart rate variability estimated cardiac sympathovagal tone. Coagulation and inflammatory activity were assessed. RESULTS: On multiple linear regression, beta-blocker use was the sole independent predictor of less severe stroke on presentation (95% CI: 0.12 to 1.86: p = 0.03). When CanNS was dichotomized, multiple logistic regression revealed that beta-blocker use (odds ratio [OR] 3.70, 95% CI: 1.24 to 11.01, p = 0.02) and female gender (OR 2.96, 95% CI: 1.14 to 7.69, p = 0.03) were independent predictors of CanNS score >8.5. There was no difference in blood pressure and blood glucose between these two groups. Beta-blocker treatment was associated with lower sympathovagal tone (p = 0.001), thrombin (p = 0.009), hemoglobin A(1)C levels (p = 0.02), and erythrocyte sedimentation rate (p = 0.003). CONCLUSION: Beta-blocker use is associated with less severe stroke on presentation and may be cerebroprotective due to a sympatholytic effect associated with decreased thrombin, inflammation, and hemoglobin A(1)C.
Somchai Laowattana; Stephen M Oppenheimer
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Neurology     Volume:  68     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-02-13     Completed Date:  2007-03-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  509-14     Citation Subset:  AIM; IM    
Baylor College of Medicine, Houston, TX, USA.
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MeSH Terms
Adrenergic beta-Antagonists / therapeutic use*
Blood Sedimentation
Hemoglobin A, Glycosylated / metabolism
Linear Models
Middle Aged
Neuroprotective Agents / therapeutic use*
Severity of Illness Index
Sex Factors
Stroke / blood,  drug therapy*,  physiopathology
Sympathetic Nervous System / physiopathology
Thrombin / metabolism
Treatment Outcome
Vagus Nerve / physiopathology
Grant Support
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Hemoglobin A, Glycosylated; 0/Neuroprotective Agents; EC

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