Еprosartan therapy effectiveness in arterial hypertension patients after stroke or transient ischemic attack

Aim. To study effectiveness, safety, and dynamics of cognitive function in eprosartan therapy among arterial hypertension (AH) patients after stroke (S) or transient ischemic attack (TIA), comparing to standard antihypertensive therapy. Material and methods. The study included 60 AH patients, who underwent S or TIA. All participants wee randomized to two equal groups. Mean age in Group I was 62,2±7,8 years, in Group II – 59,8±6,7 years; AH duration - 9,5±3,5 and 9,8±3,2 years, respectively. For 3 months, Group I received eprosartan (600 mg/d), as monotherapy or combined with hydrochlorthiazide, if target blood pressure (BP) level was not achieved. Group II received standard antihypertensive therapy. At 4 visits, BP, heart rate, body mass index were measured; medication tolerability were assessed. At the baseline and at the end of the study, electrocardiography, echocardiography, 24-hour BP monitoring (BPM), psychological testing with Beck and MMSE questionnaires were performed. Results. In 2 patients (6,7%) from control Group II, recurrent TIA episodes were registered. In both groups, a significant positive dynamics of all manually measured BP parameters was observed. At the end of the study, BP positive dynamics was more manifested in eprosartan group. Moreover, in Group I, depression and cognitive dysfunction levels substantially decreased. Conclusion. Eprosartan is an effective antihypertensive agent for AH treatment, with cerebroprotective effects in S and TIA patients, that could be used as monotherapy or in combination with a diuretic.

1. Шальнова С.А., Деев А.Д., Вихирева О.В. и др. Распространенность артериальной гипертонии в России. Информированность, лечение, контроль. Профил забол укреп здор 2001; 2: 3-7.

2. Кушаковский М.С. Эссенциальная гипертензия. Причины, механизмы, клиника, лечение. Санкт-Петербург 2002; 416: 164-8.

3. MacMahon S. Blood pressure and the risk of cardiovascular disease. N Engl J Med 2000; 342: 50-2.

4. Скворцова В.И. Эпидемиология цереброваскулярных нарушений и их связь с АГ. Руководство по артериальной гипертонии под ред. Е.И.Чазова. Москва 2005; 784: 217-45.

5. Арабидзе Г.Г., Арабидзе Гр.Г. Гипертонические кризы: классификация, диагностика осложнений, лечение. Кардиология 1999; 12: 86-90.

6. Гусев Е.И., Скворцова В.И. Ишемия головного мозга. Москва «Медицина» 2001.

7. Litbell H, Hanson L, Skoog I. The Study on Cognition and Prognosis in the Elderly (SCOPE); outcomes in patients not receiving add-on therapy after randomization. J Hypertens 2004; 22(8): 1605-12.

8. Frishman WH. Are antihypertensive agents protective against dementia? A review of clinical and preclinical data. Heart Dis 2002; 4(6): 380-6.

9. Chalmers J, MacMahon S. Perindopril protection against Recurrent Stroke Study (PROGRESS): interpretation and implementation. J Hypertens Suppl 2003; 21(5); 9-14.

10. Ольбинская Л.И. Ингибиторы ангиотензин-превращающего фермента и блокаторы рецепторов ангиотензина II при лечении артериальной гипертонии. Руководство по артериальной гипертонии под ред. Е.И.Чазова. Москва 2005; 784: 596-615.

11. Schrader J, Luders S, Kulschevski A, et al. for the MOSES study group. Morbidity and mortality after Stroke – Eprosartan vs Nitrendipine in Secondary Prevention. Principal results of a prospective randomized controlled study (MOSES). Stroke 2005; 36: 1218-26.