{"id":6423,"date":"2011-02-11T11:06:07","date_gmt":"2011-02-11T16:06:07","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?p=6423"},"modified":"2011-07-19T17:44:35","modified_gmt":"2011-07-19T21:44:35","slug":"scast-trial-provides-no-support-for-blood-pressure-lowering-in-acute-stroke","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2011\/02\/11\/scast-trial-provides-no-support-for-blood-pressure-lowering-in-acute-stroke\/","title":{"rendered":"SCAST Trial Provides No Support for Blood Pressure Lowering in Acute Stroke"},"content":{"rendered":"<div>\n<p>Lowering blood pressure with an angiotensin-receptor blocker in patients with acute stroke and hypertension produces no benefits, according to a new study presented at the International Stroke Conference\u00a0and\u00a0<a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736%2811%2960104-9\/fulltext\">published simultaneously online in the <\/a><em><a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736%2811%2960104-9\/fulltext\">Lancet<\/a>.<\/em> In the Scandinavian Candesartan Acute Stroke Trial (SCAST), investigators randomized 2029 acute stroke patients in 9 north European countries who had a systolic blood pressure of 140 mm Hg or higher to candesartan or placebo.<\/p>\n<p>At 6 months, the rate of vascular death, MI, or stroke was not significantly different between the two groups (120 events in the candesartan group versus 111 events in the placebo group, p=0.52). In addition, functional outcome at 6 months as assessed by the modified Rankin Scale was not significantly different between the groups, though a trend suggested a worse outcome in the candesartan group (p=0.048).<\/p>\n<p>The investigators concluded that unless other ongoing trials suggest otherwise, &#8220;we see no place for routine blood-pressure lowering treatment in the acute phase of stroke.&#8221;<\/p>\n<p>In <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736%2811%2960163-3\/fulltext\">an accompanying comment<\/a>, Graeme Hankey writes that the results of the trial, taken with the results of previous trials, suggest that &#8220;pharmacologically lowering blood pressure does not have an overall beneficial effect on functional outcome&#8221; and that therefore &#8220;clinicians should&#8230; not be prescribing blood-pressure-lowering drugs within the first week of acute stroke in routine practice.&#8221;<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Lowering blood pressure with an angiotensin-receptor blocker in patients with acute stroke and hypertension produces no benefits, according to a new study presented at the International Stroke Conference\u00a0and\u00a0published simultaneously online in the Lancet. In the Scandinavian Candesartan Acute Stroke Trial (SCAST), investigators randomized 2029 acute stroke patients in 9 north European countries who had a [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,16],"tags":[694,456,648],"class_list":["post-6423","post","type-post","status-publish","format-standard","hentry","category-general","category-vascular","tag-acute-stroke","tag-blood-pressure","tag-candesartan"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/6423","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=6423"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/6423\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=6423"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=6423"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=6423"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}