The Correlation between Various Types of Antihypertensive Drugs and the Incidence of Acute Stroke

Athiyya Salma Hamida, Tri Wahyuliati

Abstract


Stroke is the second leading cause of death and the third leading cause of disability, whose incidence increase with hypertension. Various antihypertensives are used as secondary therapy for stroke. However, the effectiveness of each drug is still debated. This study aims to determine the correlation between various types of antihypertensive drugs on the incidence of acute stroke. This research is a cross-sectional study. Inclusion criteria included hypertensive patients who had used antihypertensive drugs for at least a year and were aged > 36. We included 78 subjects, 47 men and 31 women. The drugs were ACEI + CCB (13), ARB (8), ARB + CCB (22), and CCB (35). The subject had an ischemic stroke (8) and a hemorrhagic stroke (1). The logistic regression test showed ACEI + CCB as a reference category. The result consecutively showed ARB (OR, 4.95; CI, 0.72 to 33.89; p = 0.103), CCB (OR, 2.61; CI, 0.39 to 17.01; p = 0.317), and ARB + CCB (OR, 2.36; CI, 0.19 to 29.75; p = 0.507). The antihypertensive drugs had no significant correlation with the incidence of acute stroke. It indicated that stroke risk was not triggered by antihypertensive and could effectively control hypertension and protect patients against stroke

Keywords


antihypertensive; hypertension; stroke

Full Text:

PDF

References


Johnson W, Onuma O, Owolabi M, Sachdev S. Bulletin of The World Health Organization 2016;94:634-634A. doi: Http://Dx.Doi.Org/10.2471/BLT.16.181636

Johansson BB. Hypertension Mechanisms Causing Stroke. Clin Exp Pharmacol Physiol. 1999 Jul;26(7):563-5. Doi: 10.1046/J.1440-1681.1999.03081.X. PMID: 10405790.

JAMA, 1991. Prevention of Stroke by Antihypertensive Drug Treatment in Older Persons with Isolated Systolic Hypertension: Final Results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA 265, 3255. https://doi.org/10.1001/jama.1991.03460240051027

Egan BM, 2007. Combination Therapy With an Angiotensin Converting Enzyme Inhibitor and a Calcium Channel Blocker 9, 7.

Rajan S, Ahuja S, Cohen B, Martin A, Pursell A, Liang C, et al. Chronic Use of Angiotensin Converting Enzyme Inhibitors and/or Angiotensin Receptor Blockers is Not Associated with Stroke After Noncardiac Surgery: A Retrospective Cohort Analysis. J Neurosurg Anesthesiol. 2022 Oct 1;34(4):401-406. doi: 10.1097/ANA.0000000000000777. Epub 2021 May 13. PMID: 34569768.

Infodatin Stroke 2019. Kementrian Kesehatan RI. 2019.

Faisal I, 2020. Karakteristik Pasien Penderita Atrial Fibrilasi di RSUP Dr. Wahidin Sudirohusodo.

Pertiwi YP, Prihanto ESD, Ambar E. Karakteristik Pasien Hipertensi Di Poliklinik Penyakit Dalam Rumah Sakit Umum Daerah Dr. H. Chasan Boesoirie Ternate. Kieraha Med. J. 2019: 1(1): .

Everett B, Zajacova A. Gender Differences in Hypertension and Hypertension Awareness among Young Adults. Biodemography Soc. Biol. 2015: 61, 1–17. https://doi.org/10.1080/19485565.2014.929488

CDC. Hypertension Cascade: Hypertension Prevalence, Treatment and Control Estimates Among US Adults Aged 18 Years and Older Applying the Criteria from the American College of Cardiology and American Heart Association’s 2017 Hypertension Guideline—NHANES 2015–2018. Atlanta, GA: US Department of Health and Human Services; 2021.

Kusumastuti LA, Julia M, Susilowati R. Hubungan antara Kadar Testosteron dan Tekanan Darah pada Remaja dengan Obesitas di Kota Yogyakarta. Thesis. University of Gadjah Mada, Yogyakarta. 2019

Riskesdas 2018. Kementrian Kesehatan RI.

Chasanah SU, Syarifah N. 2017. Hubungan Karakteristik Individu Penderita Hipertensi dengan Derajat Hipertensi di Puskesmas Depok II Sleman Yogyakarta 2, 9.

Khotimah, 2013. Stres sebagai Faktor Terjadinya Peningkatan Tekanan Darah pada Penderita Hipertensi. J. EduHealth. 2013: 3(2):79–83.

Tully PJ, Debette S, Dartigues JF, Helmer C, Artero S, Tzourio C. Antihypertensive Drug Use, Blood Pressure Variability, and Incident Stroke Risk in Older Adults: Three-City Cohort Study. Stroke, 2016 (47):1194–1200. https://doi.org/10.1161/STROKEAHA.115.012321

Sari IM. Rasionalitas Penggunaan Obat Antihipertensi pada Penderita Stroke di Instalasi Rawat Inap Rumah Sakit Umum Daerah Dr. M. Ashari Pemalang Tahun 2008 Skripsi 22.

Verdecchia P, Reboldi G, Angeli F, Gattobigio R, Bentivoglio M, Thijs L, et al. Angiotensin-Converting Enzyme Inhibitors and Calcium Channel Blockers for Coronary Heart Disease and Stroke Prevention. Hypertension 2005: (46):386–392. Https://Doi.Org/10.1161/01.HYP.0000174591.42889.A2

Lin YC, Lin JW, Wu MS, Chen KC, Peng CC, Kang YN. Effects of Calcium Channel Blockers Comparing to Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Patients with Hypertension and Chronic Kidney Disease Stage 3 to 5 and Dialysis: A Systematic Review and Meta-Analysis. PLOS ONE 2017:12, E0188975. Https://Doi.Org/10.1371/Journal.Pone.0188975

Heeley EL, Wei JW, Wang JG, Arima H, Huang Y, Wong LK, et al. Comparative effects of antihypertensive drugs on stroke outcome in China. Int J Stroke. 2014 Oct;9 Suppl A100:113-8. doi: 10.1111/ijs.12330. Epub 2014 Jul 15. PMID: 25042450.

Boehme AK, Esenwa C, Elkind MSV. Stroke Risk Factors, Genetics, and Prevention. Circ. Res. 2017:120, 472–495. Https://Doi.Org/10.1161/CIRCRESAHA.116.308398

Tandi J, Waruwu DS, Martina A. Kajian Penggunaan Antihipertensi pada Pasien Strok di Instalasi Rawat Inap RSU Anutapura Palu Tahun 2017. Indones. J. Clin. Pharm. 2018: 7, 260. Https://Doi.Org/10.15416/Ijcp.2018.7.4.260

Abraham HMA, White CM, White WB. The Comparative Efficacy and Safety of The Angiotensin Receptor Blockers in The Management of Hypertension and Other Cardiovascular Diseases. Drug Saf. 2015: 38, 33–54. Https://Doi.Org/10.1007/S40264-014-0239-7

Chen GJ, Yang MS. The Effects of Calcium Channel Blockers in The Prevention of Stroke in Adults with Hypertension: A Meta-Analysis of Data from 273,543 Participants in 31 Randomized Controlled Trials. Plos One 2013: 8, E57854. Https://Doi.Org/10.1371/Journal.Pone.0057854

Kalar I, Xu H, Secnik J, Schwertner E, Kramberger MG, Winblad B, et al. Calcium Channel Blockers, Survival and Ischaemic Stroke in Patients with Dementia: A Swedish Registry Study. J. Intern. Med. 2021:289, 508–522. Https://Doi.Org/10.1111/Joim.13170

Luscher TF, Cosentino F. The Classification of Calcium Antagonists and Their Selection in The Treatment of Hypertension: A Reappraisal. Drugs 1998: 55, 509–517. Https://Doi.Org/10.2165/00003495-199855040-00003

Khalil H, Zeltser R. Antihypertensive Medications. Statpearls Publ. 2020 (17). [Updated 2022 Jan 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554579/?report=classic

Tai C, Gan T, Zou L, Sun Y, Zhang Y, Chen et al. Effect of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers on Cardiovascular Events in Patients with Heart Failure: A Meta-Analysis of Randomized Controlled Trials. BMC Cardiovasc. Disord. 2017: 17, 257. Https://Doi.Org/10.1186/S12872-017-0686-Z

Armario P, De La Sierra A. Antihypertensive Treatment and Stroke Prevention: Are Angiotensin Receptor Blockers Superior to Other Antihypertensive Agents? Ther. Adv. Cardiovasc. Dis. 2009: 3, 197–204. Https://Doi.Org/10.1177/1753944709104164

Wanas Y, Bashir R, Islam N, Furuya-Kanamori L. Assessing the risk of angiotensin receptor blockers on major cardiovascular events: a systematic review and meta-analysis of randomized controlled trials. BMC Cardiovasc Disord. 2020 Apr 21;20(1):188. doi: 10.1186/s12872-020-01466-5.

Mann JF. Choice of drug therapy in primary (essential) hypertension 34. 2021. https://www.uptodate.com/contents/choice-of-drug-therapy-in-primary-essential-hypertension/print

Hong KS. Blood Pressure Management for Stroke Prevention and in Acute Stroke. J. Stroke. 2017:19, 152–165. https://doi.org/10.5853/jos.2017.00164




DOI: https://doi.org/10.18196/mmjkk.v23i1.13955

Refbacks



Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.


      

Editorial Office:
Journal Room, G1 (Biomedic) Building, Ground Floor, Faculty of Medicine and Health Science Universitas Muhammadiyah Yogyakarta, 
Jalan Lingkar Selatan (Brawijaya), Tamantirto, Kasihan, Bantul, Daerah Istimewa Yogyakarta, Indonesia
Phone: +62 274 387 656 (ext: 231)
WA : +62 811-2650-303
Website: http://journal.umy.ac.id/index.php/mm 
E-mail: mmjkk@umy.university

Creative Commons License
Mutiara Medika: Jurnal Kedokteran dan Kesehatan is licensed under a Creative Commons Attribution 4.0 International License. View My Stats