What antihypertensive drugs are prescribed for patients with stroke in Japan? -Fukuoka Stroke Registry Study

• Published in: Japanese Journal of Stroke Vol. 32; no. 3; pp. 275 - 281
• Main Authors: Nakane, Hiroshi, Kitayama, Jiro, Kumai, Yasuhiro, Higashi, Saho, Kitazono, Takanari
• Format: Journal Article
• Language: Japanese
• Published: The Japan Stroke Society 25.05.2010
• Subjects: angiotensin II recepotor blocker; calcium antagonist; hypertension; secondary prevention; stroke
• ISSN: 0912-0726; 1883-1923
• DOI: 10.3995/jstroke.32.275

Background and Purpose: In Japan, calcium antagonists have traditionally been prescribed for secondary prevention of stroke. However, the PROGRESS study, which showed the effectiveness of angiotensin converting enzyme inhibitors and diuretics to prevent stroke recurrence, should have influenced the selection of antihypertensive drugs. The purpose of this study was to survey the recent trends in the use of antihypertensive drugs for patients with stroke. Methods: Among 2,153 patients with acute stroke in the Fukuoka Stroke Registry, 1,576 hypertensive patients were enrolled in this study. We studied stroke subtypes, prescribed antihypertensive drugs before admission and at discharge, and blood pressure levels at day 30 after admission. Results: Antihypertensive drugs were prescribed to 860 patients (54.6% of enrolled patients) at discharge. Inhibitors of renin-angiotensin system (angiotensin converting enzyme inhibitor and angiotensin II receptor blocker) were most frequently prescribed (34.3%), followed by calcium antagonists (27.4%). Regarding 1,176 first-ever stroke patients, the most prescribed antihypertensive drugs before admission were calcium antagonists (64.9% of first-ever stroke patients with antihypertensive drugs) followed by inhibitors of the renin-angiotensin system (55.0%). However, inhibitors of the renin-angiotensin system were most frequently prescribed at discharge (66.7%) followed by calcium antagonists (47.7%). Blood pressure level at day 30 after admission showed good control level in all ages (systolic blood pressure range was 130-34 mmHg and diastolic pressure was 70-84 mmHg). Conclusions: Our study revealed that inhibitors of the renin-angiotensin system are replacing calcium antagonists as the most preferable antihypertensive drugs for secondary prevention of stroke.