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In hypertensive acute stroke patients, the use of antihypertensive treatment is often
delayed because autoregulation of cerebral blood flow (CBF) is often impaired during
the first 4 weeks after large brain infarctions. However, little is known as to whether
such delay is necessary in cases of small to moderate size brain infarction. We compared
changes of regional CBF during antihypertensive treatment in subacute and chronic
phases of lacunar infarction. Blood pressure was controlled with an angiotensin-converting
enzyme inhibitor (n=6) or dihydropyridine calcium antagonist (n=8), administered orally
for 2 weeks during the subacute (n=7) and chronic phases after (n=7) lacunar infarction.
CBF was measured by the stable xenon-computed tomography (CT) method. Blood pressure
decreased significantly from 132±20 mm Hg (mean±standard deviation) to 118±14 mm Hg
(P<.05, paired t-test) in subacute patients and from 135±17 mm Hg to 113±12 mm Hg (P<.001, paired t-test) in chronic patients. There was no significant reduction either in mean hemispheric
blood flow or in deep white matter blood flow during each phase. We condlude that
mild control of blood pressure among hypertensive patients with lacunar infarctions
does not produce clinically significant decreases in regional CBF during subacute
phases of infarction.
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Article info
Publication history
Accepted:
January 28,
1997
Received:
January 8,
1997
Footnotes
*Supported in part by Ciba Geigy Japan Limited.
Identification
Copyright
© 1997 National Stroke Division. Published by Elsevier Inc.
