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Bendrofluazide fails to reduce elevated blood pressure levels in the immediate post-stroke period.

AbstractINTRODUCTION:
Blood pressure (BP) levels, beat-to-beat blood pressure variability, dynamic cerebral autoregulation and cardiac baroreceptor sensitivity are frequently abnormal following acute stroke and are associated with an adverse short- and long-term prognosis. Thiazide diuretics are effective antihypertensive agents in preventing primary and secondary stroke, but their hypotensive and cerebral autoregulatory effects in the immediate post-stroke period have not been studied.
METHODS:
Thirty-seven hypertensive neuroradiologically proven ischaemic stroke patients were randomized in a double-blind, placebo controlled, parallel group study to bendrofluazide 2.5 mg daily or matching placebo, within 96 h of stroke onset, for a 7-day period. Casual and non-invasive beat-to-beat arterial BP levels, cerebral blood flow velocity, ECG and transcutaneous carbon dioxide levels were measured within 70 +/- 20 h of cerebral infarction and again 7 days later. Dynamic cerebral autoregulatory indices, pulse interval, BP variability and cardiac baroreceptor sensitivity were also calculated.
RESULTS:
Small, non-significant falls were seen in casual and beat-to-beat BP levels over the 7-day period in both active and placebo-treated patients with no differences between treatments. No significant changes were seen in dynamic cerebral autoregulation or in cardiac baroreceptor sensitivity during the follow-up in either group.
CONCLUSION:
Following acute ischaemic stroke, the standard dose of bendrofluazide at 2.5 mg daily in this study sample did not lower systemic BP levels over the subsequent 7-day period. There was no evidence that bendrofluazide significantly altered cerebral autoregulation or improved cardiac baroreceptor sensitivity post-ictus. Bendrofluazide appears to be an ineffective hypotensive agent at the standard dosage in the initial post-stroke period.
AuthorsPenelope J Eames, Thompson G Robinson, Ronney B Panerai, John F Potter
JournalCerebrovascular diseases (Basel, Switzerland) (Cerebrovasc Dis) Vol. 19 Issue 4 Pg. 253-9 ( 2005) ISSN: 1015-9770 [Print] Switzerland
PMID15731556 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
CopyrightCopyright 2005 S. Karger AG, Basel.
Chemical References
  • Antihypertensive Agents
  • Bendroflumethiazide
Topics
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents (administration & dosage)
  • Bendroflumethiazide (administration & dosage)
  • Blood Pressure (drug effects)
  • Female
  • Humans
  • Hypertension (drug therapy)
  • Male
  • Middle Aged
  • Stroke (drug therapy)
  • Treatment Failure

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