PP.29.19] USE OF BETA-BLOCKERS IS NOT ASSOCIATED WITH POOR SHORT-TERM OUTCOME IN HYPERTENSIVE PATIENTS WITH STROKE

Abstract

Objective: Most current guidelines no longer recommend beta-blockers (BBs) as the first line treatment for hypertension. The impact of treatment with BBs on stroke outcome is unclear. We used data from a prospective national stroke registry to assess the associations between use of BBs and 3-months functional outcome and mortality after stroke. Design and method: Using the National Acute Stroke Israeli (NASIS) 2007–2013 registry we identified 1131 patients with ischemic stroke and intracerebral hemorrhage who were followed for 3-months and had data on hypertension status and treatment before admission. Poor functional outcome (Barthel Index less than or equal to 60) and mortality 3 months after stroke were compared between users and non-users of BBs. Rates of poor outcome and odds-ratios (ORs) were adjusted for age, gender, stroke type, stroke severity, known cardiovascular risk factors, cancer and use of statins. Results: Mean (SD) age of the study population was 72.5 (11.5) years, and 55.6% were men. Pre-stroke use of BBs was reported by 619 (54.7%) patients. There was no significant difference in age, sex and systolic blood pressure levels between users and non-users of BBs. Users of BBs showed higher rates of atrial fibrillation (p = 0.0009), heart disease (p < .0001), statin use (p < .0001) and cancer (p = 0.006). Rate of severe stroke (NIHSS above or equal to 11) was higher in patients on BBs (p = 0.03). Rates of 3-month mortality and poor functional outcome were similar in users and non-users of BBs (7.1% and 6.1% for mortality and 35.5% and 34.8% for poor functional outcome respectively). Adjusted ORs was 1.1 (0.6–1.9) for mortality and 1.0 (0.7–1.4) for functional outcome in users vs. non-users of BBs. Conclusions: Treatment with BBs is not associated with short-term poor outcome in hypertensive patients.