Effect of antihypertensive agents ACEI/ARB and CCB on hypertensive intracerebral hemorrhage and inflammatory cytokines, serum ferritin, and serum P

Abstract

The aim of this study was to investigate the effect of angiotensin-converting enzyme inhibitor (ACEI)/angiotensin II receptor blocker (ARB) and calcium channel blocker (CCB) antihypertensive drugs on the treatment of hypertensive intracerebral hemorrhage (ICH) and on the expression level of inflammatory factors, serum ferritin (SF), and serum substance P (SP). A total of 160 patients with hypertensive ICH were divided into three groups according to the type of antihypertensive drugs taken before cerebral hemorrhage: group A (40 cases, taking ACEI/ARB antihypertensive drugs before cerebral hemorrhage), group B (40 cases, CCB antihypertensive drugs were regularly taken before the onset of cerebral hemorrhage), and C group (80 cases, nor any antihypertensive drugs were regularly taken before the onset of cerebral hemorrhage). Patients in group C were further divided into two groups: group D (40 cases, ARB antihypertensive drugs were regularly taken after cerebral hemorrhage) and group E (40 cases, CCB antihypertensive drugs were regularly taken after cerebral hemorrhage). On the third day, after the onset of disease, the level of serum interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, SF, and SP in all the patients was detected. At the same time, the brain computed tomography (CT) was used to evaluate the cerebral edema. On the first day and the thirty day after the onset of disease, the patient’s neurological deficit status was assessed according to the National Institutes of Health Stroke Scale (NIHSS) score. On the third day after onset, the levels of IL-1β, IL-6, TNF-α, SF, and the volume of cerebral edema in group A and group B were significantly lower than those in group C ( P < 0.05). The level of serum SP in group A and group B was significantly higher than that in group C ( P < 0.05). However, there was no significant difference between group A and group B ( P > 0.05). On the third day after onset, the mortality of each group is of no significant difference ( P > 0.05). However, NIHSS scores in group A and group B were significantly lower than those in group C ( P < 0.05). There was no statistical difference in NIHSS scores between group A and group B ( P > 0.05). In conclusion, in the early stage of hypertensive ICH, early normative use of ACEI/ARB or CCB antihypertensive drugs can improve the prognosis of patients, whose mechanism may be related to the improvement of level of serum inflammatory factors and SP and SF.