PMID- 19745828
OWN - NLM
STAT- Publisher
DA  - 20090911 
IS  - 0916-9636 (Print)
DP  - 2009 Sep 11
TI  - Benefits of the angiotensin II receptor antagonist olmesartan in controlling
      hypertension and cerebral hemodynamics after stroke.
AB  - The purpose of this study was to assess the relative benefits of angiotensin II
      receptor blockers (ARBs) and calcium channel blockers (CCBs) on cerebral
      hemodynamics and rehabilitation outcome in hypertensive stroke patients. We
      randomly assigned 35 patients to either the olmesartan (n=18) or amlodipine
      (n=17) treatment groups for 8 weeks. Changes in cerebral blood flow (CBF) and
      cerebrovascular reserve capacity (CRC) were quantified using xenon-CT and
      rehabilitation parameters were also measured. Over 24 h, olmesartan and
      amlodipine both reduced blood pressure (BP) to similar levels (systolic BP,
      -16.1+/-2.7 mm Hg vs. -15.7+/-3.1; diastolic BP, -9.2+/-2.9 vs. -8.6+/-3.3 mm
      Hg, respectively). In olmesartan-treated patients, CBF significantly increased
      in the affected and unaffected hemispheres, and CRC increased significantly in
      the affected hemisphere. No increases in CBF and CRC were observed in
      amlodipine-treated patients. Patients treated with olmesartan showed effective
      rates of improvement in hand (30.0%), upper extremities (40.0%) and lower
      extremities (100.0%), measured by Brunnstrom stage; these improvements were
      significantly different from those in amlodipine-treated patients for the total
      (P<0.02) and lower extremity (P<0.05) scores. There were no significant
      differences in Barthel indices and Mini-Mental State Examination (MMSE) scores.
      Olmesartan, but not amlodipine, had beneficial effects on CBF, CRC and
      rehabilitation outcomes in hypertensive stroke patients, by a mechanism
      independent of BP reduction and possibly by normalizing CBF autoregulation. Our
      results suggest that olmesartan may improve cerebral circulation and
      rehabilitation in hypertensive stroke patients in whom CBF autoregulation is
      impaired.Hypertension Research advance online publication, 11 September 2009;
      doi:10.1038/hr.2009.143.
AD  - Department of Rehabilitation and Physical Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
AU  - Matsumoto S 
AU  - Shimodozono M 
AU  - Miyata R 
AU  - Kawahira K
LA  - ENG
PT  - JOURNAL ARTICLE
DEP - 20090911
TA  - Hypertens Res
JT  - Hypertension research : official journal of the Japanese Society of Hypertension
JID - 9307690
EDAT- 2009/09/12 06:00
MHDA- 2009/09/12 06:00
CRDT- 2009/09/12 06:00
PHST- 2009/09/11 00:00[aheadofprint]
AID - hr2009143[pii]
AID - 10.1038/hr.2009.143[doi]
PST - aheadofprint
SO  - Hypertens Res. 2009 Sep11 Epub 2009 09 11.