Iranian Journal of Neurology 2017. 16(1):.

A double blind case-control study of hypertensive stroke patients prognosis after amlodipine treatment in comparison to captopril
Bahareh Bazooyar

Abstract


Background: Stroke is a major cause of death and disability. Recent investigations suggest that increased cellular calcium concentrations may be implicated in neuronal death after ischemia .Calcium channel blockers such as amlodipine inhibit cellular oxidative stress and  may be effective in the treatment of cerebrovascular stroke and decrease excessive apoptosis. Objective:This study tests the hypothesis that amlodipine is superior to captopril in reducing neurological deficit and improving functional outcome in patients with acute cerebral infarction of an intermediate severity .Methods: This multicenter, double-blind, case-controlled trial randomized 124 stroke patients with just hypertension(mean arterial pressure:140-180mmHg) as a risk factor (cases mean age:66.20±8.78 and controls mean age:67.19±9.04) in Babol with a National Institutes of Health Stroke Scale score(NIHH) 6 to 14. 63 cases received amlodipine (5-10mg daily) and the other 61 controls were treated with captopril(25-75mg daily) after 72 hours of the onset of symptoms of an acute ischemic stroke for 3 months.Results:Baseline NIHHS and Barthel index were measured and compared with these scores after 3 month treatment.Although there were no statistical significant differences in primary scores in two groups(NIHH;10.47 vs 9.75, p=0.422>0.05, CI:95%, Barthel;28.80 vs 33.52, p=0.126>0.05, CI=95%), Amlodipine produced statistically significant mean improvements in NIHH(3.39 vs 4.83, p=0.016<0.05, CI=95%) and Barthel index(75.47 vs 60.16, p=0.02<0.05, CI=95%) compared with captopril after 3 month treatment.Conclusion: Our data suggests that patients with acute ischemic stroke may benefit from early treatment with amlodipine.


Keywords


Ischemicstroke,stroke prognosis,amlodipine,captopril, neuroprotection

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