Modest blood pressure reduction with valsartan in acute ischemic stroke: a prospective, randomized, open‐label, blinded–end‐point trial. Issue 5 (12th January 2015)

• Record Type: Journal Article
• Authors: Oh, Mi Sun; Yu, Kyung‐Ho; Hong, Keun‐Sik; Kang, Dong‐Wha; Park, Jong‐Moo; Bae, Hee‐Joon; Koo, Jaseong; Lee, Juneyoung; Lee, Byung‐Chul; Valsartan Efficacy oN modesT blood pressUre REduction in acute ischemic stroke (VENTURE) study group
• Is Part Of: International journal of stroke. Volume 10:Issue 5(2015:Jul.)
• Page Start: 745
• Page End: 751
• Publication Date: 2015-01-12
• Subjects: 616.8005
• DOI: 10.1111/ijs.12446
• Languages: English
• ISSNs: 1747-4930

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ijs12446-sec-0001" sec-type="section"> <title>Background and aims</title> <p>To assess the efficacy and safety of modest blood pressure (BP) reduction with valsartan within 48 h after symptom onset in patients with acute ischemic stroke and high BP.</p> </sec> <sec id="ijs12446-sec-0002" sec-type="section"> <title>Methods</title> <p>This was a multicenter, prospective, randomized, open‐label, blinded–end‐point trial. A total of 393 subjects were recruited at 28 centers and then randomly assigned in a 1:1 ratio to receive valsartan (<italic>n</italic> = 195) or no treatment (<italic>n</italic> = 198) for seven‐days after presentation. The primary outcome was death or dependency, defined as a score of 3–6 on the modified Rankin Scale (mRS) at 90 days after symptom onset. Early neurological deterioration (END) within seven‐days and 90‐day major vascular events were also assessed.</p> </sec> <sec id="ijs12446-sec-0003" sec-type="section"> <title>Results</title> <p>There were 372 patients who completed the 90‐day follow‐up. The valsartan group had 46 of 187 patients (24·6%) with a 90‐day mRS 3–6, compared with 42 of 185 patients (22·6%) in the control group (odds ratio [OR], 1·11; 95% confidence interval [CI], 0·69–1·79; <italic>P</italic> = 0·667). The rate of major vascular events did not differ between groups (OR, 1·41; 95% CI, 0·44–4·49; <italic>P</italic> = 0·771). There was a significant increase of END in the valsartan group (OR, 2·43; 95% CI, 1·25–4·73; <italic>P</italic> = 0·008).</p> </sec> <sec id="ijs12446-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Early reduction of BP with valsartan did not reduce death or dependency and major vascular events at 90 days, but increased the risk of END.</p> </sec> </abstract>