Abstract
Background and Purpose: Loweringbloodpressure (BP)withbeta-blockers is less effective in reducing the risk of stroke than with other agents. However, studies on associations between use of beta-blockers and stroke severity are inconclusive. We assessed the association between pre-stroke use of betablockers and stroke severity, disability and death in a large prospective national registry of hospitalized hypertensive patients with acute stroke. Methods: All 4299 treated hypertensive patients with ischemic stroke (91%) or intra cerebral hemorrhage (9%) registered in the National Acute Stroke Israeli (NASIS) were included. Admission medical treatment for hypertension was self-reported by medication type (beta-blockers, diuretics, calcium antagonists, blockers of the renin angiotensin system) and number of medications. Odds-ratios (ORs) for stroke severity by the National Institutes of Health Stroke Scale (NIHSS) score, functional status by the modified Rankin Score (mRS) and disability at discharge or death (mRS 2) adjusted for age, gender, stroke type and severity, systolic blood pressure (SBP) and other comorbidities were calculated for patients treated with beta-blockers vs. non-treated. Results: Among 4299 participants, 2239 (52%) reported use of beta-blockers. Mean (SD) SBP was lower in patients on beta-blockers (158.2 (29.3) mmHg) compared to others (161.0 (28.9) mmHg) (p1⁄40.002). Adjusted ORs (95% CIs), for all outcomes, were not significantly increased for patients on betablockers compared to other agents: 1.13 (0.96-1.32) for severe stroke, 0.90 (0.76-1.06) for in-hospital death and 1.01 (0.77-1.33) for disability or death at discharge. Findings were similar for patients on monotherapy. Conclusion: Treatment with beta-blocker was not associated with stroke severity, death during hospitalization and disability or death at discharge in a large national registry of hospitalized acute stroke patients.
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