Effect of the angiotensin II type 1 receptor antagonist olmesartan on cerebral hemodynamics and rehabilitation outcomes in hypertensive post-stroke patients.

PRIMARY

OBJECTIVE

In patients with severe hypertension, chronic heart failure or history of stroke, the lower limit of cerebral blood flow (CBF) autoregulation is shifted to a higher blood pressure (BP) than in healthy subjects. This study investigated the effects of the angiotensin II receptor blocker (ARB) olmesartan on human cerebral haemodynamics and rehabilitation outcomes.

RESEARCH

DESIGN

Open treatment trial with pre-treatment and post-treatment evaluations.

EXPERIMENTAL INTERVENTIONS: Olmesartan (10-20 mg) administered daily for 8 weeks.

METHODS AND PROCEDURES: The 24-hour BP, clinical BP, CBF at rest, cerebrovascular reserve capacity (CRC) and rehabilitation outcomes (Brunnstrom stage, Barthel index and Mini-Mental State Examination [MMSE] score) were measured in 44 post-stroke patients with hypertension (62.2 +/- 10.7 years).

MAIN OUTCOMES AND

RESULTS

The systemic BP decreased after treatment compared with baseline. The CBF increased by 11.2% on the affected side and by 8.9% on the non-affected side of the brain and the CRC also increased on both sides. Improvements were observed in the Brunnstrom stage, Barthel index and MMSE score.

CONCLUSIONS

This study suggest that olmesartan has beneficial effects in post-stroke patients with hypertension and impaired CBF autoregulation and provides important information necessary to design future more definitive studies.