Effect of immediate blood pressure reduction on post-stroke depression in ischemic stroke patients: A substudy of CATIS trial

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作   者：

Zhu, Zhengbao;  Guo, Daoxia;  Shi, Mengyao;  Bu, Xiaoqing;  Xie, Xuewei;  Xu, Tan;  Han, Yongfeng;  Xu, Tian;  Geng, Deqin;  Chen, Jing;  Liu, Liping;  He, Jiang;  Zhang, Yonghong; 

作者机构：

Capital Med Univ;  Med Coll;  Soochow Univ;  Kerqin Dist First Peoples Hosp Tongliao City;  Nantong Univ;  Xuzhou Med Univ;  Tulane Univ;  Beijing Tiantan Hosp;  Dept Neurol;  Affiliated Hosp;  Sch Publ Hlth & Trop Med; 

关键词：

Antihypertensive therapy;  MANAGEMENT;  Acute ischemic stroke;  Clinical trial;  CLASSIFICATION;  Post-stroke depression;  ANTIHYPERTENSIVE TREATMENT; 

期刊名称：

Journal of affective disorders

i s s n：

0165-0327

年卷期：

2022 年 300 卷

页   码：

195-202

页   码：

摘   要：

Background: Several prospective studies have identified that hypertension is an important risk factor of post-stroke depression (PSD). However, the effect of immediate antihypertensive treatment on the risk of PSD in patients with acute ischemic stroke remains unknown. Methods: In this prespecified depression substudy of the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS) randomized clinical trial, a total of 642 patients with acute ischemic stroke within 48 h of onset and elevated systolic BP at 7 sites of CATIS were included. Patients were randomly assigned to receive antihypertensive treatment (n = 318) or to control group (n = 324). The primary outcome was depression (Hamilton Rating Scale for Depression score >= 8) at 3-month posttreatment follow-up. Results: At 24 h after randomization, the mean systolic BP was reduced by 21.6 mm Hg (12.5%) in the treatment group and 13.9 mm Hg (7.9%) in the control group (difference, -7.7 mm Hg [95% CI, -10.2 to -5.2]; P<0.001). The mean systolic BP levels at 7 days (P<0.001) and 14 days (P<0.001) after randomization in treatment group were also significantly lower than those in control group. At 3-month posttreatment follow-up, 122 patients (38.4%) in antihypertensive treatment group and 131 patients (40.4%) in control group developed PSD (odds ratio, 0.92 [95% CI, 0.67 to 1.26]; P = 0.59). Limitations: All patients in the CATIS trial were Chinese, which might limit the generalizability of our findings to other populations. Conclusions: Early antihypertensive treatment had no effect on the risk of PSD at 3 months among patients with acute ischemic stroke and elevated BP.