Anti-adrenergic medications and edema development after intracerebral hemorrhage
L H Sansing1, S R Messe, B L Cucchiara
1Department of Neurology, University of Connecticut Health Center, 263 Farmington Avenue, MC 3401, Farmington, CT 06030, USA. sansing@uchc.edu
Background:
Use of antihypertensive medications is common after intracerebral hemorrhage (ICH). Medications that block adrenergic activation (e.g., beta-blockers and the alpha(2)-agonist, clonidine) may reduce the inflammatory response and therefore have secondary benefit after ICH.
Methods:
The patients with acute ICH enrolled in the placebo arm of the CHANT trial were included. Univariate and multivariate analyses were undertaken for factors associated with blood pressure medication use, edema at 72 h, and clinical outcome at 90 days.
Results:
Of the 303 patients, 87.8% received some antihypertensive treatment during the first 72 h of hospitalization. Edema volume on neuroimaging at 72 h was independently associated with clinical outcome. Use of anti-adrenergic medications was associated with less edema after controlling for hemorrhage volume and blood pressure.
Conclusions:
Antihypertensive medications that antagonize the sympathetic nervous system may reduce perihematomal edema after ICH.
Related Concept Videos
01:19Cerebral Edema l: Introduction
01:30Adrenergic Agonists: Therapeutic Uses
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and anaphylaxis:...
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
01:22Cerebral Edema ll: Pathophysiology
01:21Cytotoxic Edema: Pathophysiology
01:22Adrenergic Antagonists: Pharmacological Actions of ɑ-Receptor Blockers
α1-blockers: These drugs inhibit α1-adrenoceptors on smooth muscle cells, resulting in vasodilation. This vasodilation lowers blood pressure, making α1-blockers valuable in treating hypertension. Additionally, α1-blockers effectively address urinary obstruction...