Clinical association between intensive antihypertensive therapy and post-stroke depression in patients with acute ischemic stroke
- VernacularTitle:强化降压治疗与急性缺血性卒中患者卒中后抑郁的临床关系
- Author:
Yan HU
1
;
Shucheng GANG
1
Author Information
- Publication Type:Journal Article
- Keywords: Antihypertensive treatment; Acute ischemic stroke; Post-stroke depression; Safety
- From: Journal of Apoplexy and Nervous Diseases 2023;40(9):802-806
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the effect of antihypertensive therapy on post-stroke depression （PSD） in patients with acute ischemic stroke. Methods A total of 83 patients who were diagnosed with ischemic stroke by computed tomography or brain magnetic resonance imaging within 48 hours after the appearance of symptoms from August 2020 to January 2022 were enrolled in this study， and they were divided into intensive antihypertensive therapy group （intensive group with 41 patients） and standard antihypertensive therapy group （standard group with 42 patients） using a random number table. The goal of the intensive group was to reduce systolic blood pressure to <130 mmHg， and the goal of the standard group was to reduce systolic blood pressure to <140 mmHg. The primary outcome was the incidence rate of PSD during follow-up for 6 months after treatment， which was defined as ≥8 points for Hamilton Rating Scale for Depression-24 Items （HRSD-24）， and secondary outcomes were cognitive tests ［Addenbrooke's Cognitive Examination Revised （ACE-R） and Stroop test］ and activities of daily living （Barthel Index）. The safety outcome was a serious adverse event. Results After 6 months of treatment， compared with the relative changes of systolic blood pressure and diastolic blood pressure in the standard group， the systolic blood pressure and diastolic blood pressure in the intensive group were reduced by 10.6 mmHg and 5.5 mmHg， respectively （P<0.001 and P=0.004）. In addition， the relative change of heart rate during treatment in the intensive group was reduced by 5.0 bmp compared with that in the standard group （P=0.034）. After adjustment for random variables， there was no significant difference in the primary outcome （HRSD score） between the intensive group and the standard group during the treatment period， and HRSD score in the intensive group was reduced by 1.2 （95%CI -0.8 to 1.1， P=0.105）. As for the secondary outcomes， compared with the standard group， the intensive group had significant reductions in ACE-R （P=0.045） and mRS （P=0.036） and significant increases in the scores of accuracy （P=0.027）， interference accuracy （P=0.033）， and animal naming （P=0.008） in Stroop test. There was no significant difference in the overall incidence rate of serious adverse events between the two groups at the end of the trial （χ2=0.597， P=0.440）. Conclusion Intensive antihypertensive therapy has an acceptable safety profile in patients with acute ischemic stroke， but it cannot reduce the risk of PSD.
- Full text:2024061415325905447强化降压治疗与急性缺血性卒中患者卒中后抑郁的临床关系.pdf
