A research project at the University of Leicester in conjunction with the University of East Anglia, indicates that early reduction of high blood pressure following stroke is feasible and safe, and both Labetalol & Lisinopril were found to be suitable a medications for this purpose.
Larger studies will now be necessary to confirm this result and test the effects on recovery from stroke.
Amit Mistri, a postgraduate researcher working on this project commented: "Stroke is a debilitating condition with high death and dependency rates. There are many unanswered dilemmas in the early management of people who have suffered a stroke.
"For early treatment of strokes caused by a clot in the circulation, aspirin is the only medication shown to be beneficial (small benefit), and clot-dissolving treatment (thrombolysis) is applicable to a minority only. No evidence-based treatment exists for early management of strokes secondary to bleeding within the brain. Elevated blood pressure represents a new therapeutic target in the early management of both types of stroke."
The research was funded and sponsored by the National Health Service Research and Development Health Technology Assessment Programme of the Department of Health.
Elevated peak arterial blood pressure (systolic blood pressure - SBP) following a stroke has been associated with worse outcome. It is not known whether early lowering of high SBP would be beneficial in improving outcome following stroke.
The research in Leicester was carried out as part of CHHIPS, a multicentre UK-based study, which compared the SBP lowering efficacy of two medications (labetalol and lisinopril) with dummy medication (placebo).
179 patients with high SBP (>160 mmHg) were randomly allocated to receive labetalol, lisinopril or a placebo. The dose was increased over the first 12 hours to attain a pre-specified SBP target, and continued for 2 weeks. Alternative formulations were available for those unable to swallow.