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Hypertension and experimental stroke therapies

Citation

Collins, VE and Donnan, GA and Macleod, MR and Howells, DW, Hypertension and experimental stroke therapies, Journal of Cerebral Blood Flow and Metabolism, 33 pp. 1141-1147. ISSN 0271-678X (2013) [Refereed Article]

DOI: doi:10.1038/jcbfm.2013.88

Abstract

Hypertension is an established target for long-term stroke prevention but procedures for management of hypertension in acute stroke are less certain. Here, we analyze basic science data to examine the impact of hypertension on candidate stroke therapies and of anti-hypertensive treatments on stroke outcome. Methods: Data were pooled from 3,288 acute ischemic stroke experiments (47,899 animals) testing the effect of therapies on infarct size (published 19782010). Data were combined using meta-analysis and meta-regression, partitioned on the basis of hypertension, stroke model, and therapy. Results: Hypertensive animals were used in 10% of experiments testing 502 therapies. Hypertension was associated with lower treatment efficacy, especially in larger infarcts. Overall, anti-hypertensives did not provide greater benefit than other drugs, although benefits were evident in hypertensive animals even when given after stroke onset. Fifty-eight therapies were tested in both normotensive and hypertensive animals: some demonstrated superior efficacy in hypertensive animals (hypothermia) while others worked better in normotensive animals (tissue plasminogen activator, anesthetic agents). Discussion: Hypertension has a significant effect on the efficacy of candidate stroke drugs: standard basic science testing may overestimate the efficacy which could be reasonably expected from certain therapies and for hypertensive patients with large or temporary occlusions.

Item Details

Item Type:Refereed Article
Keywords:acute stroke; animal models; brain ischemia; hypertension; neuroprotection
Research Division:Medical and Health Sciences
Research Group:Neurosciences
Research Field:Neurology and Neuromuscular Diseases
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Nervous System and Disorders
Author:Howells, DW (Professor David Howells)
ID Code:100994
Year Published:2013
Web of Science® Times Cited:12
Deposited By:Office of the School of Medicine
Deposited On:2015-06-05
Last Modified:2017-11-06
Downloads:0

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