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Updated: Aug 22, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Effect of Immediate Antihypertensive Treatment on Clinical Outcomes in Acute Ischemic Stroke Patients With Different
Yujia Zhai1, Bizhong Che1, Yang Liu2,3
1Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, China (Y.Z., B.C., H.P., A.W., Y.Z., T.X., C.Z.).
Insights
Early blood pressure management in acute ischemic stroke patients showed no significant difference in outcomes, regardless of kidney function. This study analyzed data from the CATIS trial, finding a neutral effect across different estimated glomerular filtration rate (eGFR) levels.
Area of Science:
- Neurology
- Nephrology
- Cardiology
Background:
- Optimal blood pressure management in acute stroke patients with varying renal function remains unclear.
- The China Antihypertensive Trial in Acute Ischemic Stroke (CATIS) investigated this question.
Purpose of the Study:
- To analyze the effect of early antihypertensive treatment on acute ischemic stroke patients based on baseline renal function.
- To stratify outcomes by estimated glomerular filtration rates (eGFR).
Main Methods:
- Secondary analysis of the CATIS trial involving 4071 acute ischemic stroke patients.
- Patients were assigned to antihypertensive treatment or control (discontinue medication).
- Outcomes were compared across eGFR groups: <60, 60-89, and ≥90 mL/min per 1.73 m².
Main Results:
- No significant difference in the primary outcome (death or major disability) between treatment and control groups across all eGFR strata (P=0.98 for homogeneity).
- Odds ratios for the primary outcome were 1.23 (<60 eGFR), 0.94 (60-89 eGFR), and 1.04 (≥90 eGFR).
- Early antihypertensive treatment showed no association with secondary clinical outcomes based on renal function.
Conclusions:
- Early antihypertensive treatment demonstrated a neutral effect on clinical outcomes in ischemic stroke patients.
- Renal function status did not alter the impact of early antihypertensive treatment on stroke outcomes.
Background:
It remains unclear whether different blood pressure management strategies should be administered for acute stroke patients with or without impaired renal function. We conducted a secondary analysis of the CATIS trial (China Antihypertensive Trial in Acute Ischemic Stroke) to investigate the effect of early antihypertensive treatment among patients with acute ischemic stroke according to the baseline renal function assessed by estimated glomerular filtration rates (eGFR).
Methods:
The CATIS trial randomly assigned 4071 acute ischemic stroke patients with systolic blood pressure between 140 and 220 mm Hg to receive antihypertensive treatment or to discontinue all antihypertensive medications during hospitalization. A primary outcome (composite outcome of death and major disability) and secondary outcomes were compared between antihypertensive treatment and control groups by baseline renal function levels of eGFR values of <60, 60 to 89, and ≥90 mL/min per 1.73 m2.
Results:
At day 14 or hospital discharge, the primary outcome was not significantly different between the antihypertensive treatment and control groups in each subgroup stratified by renal function status (P=0.98 for homogeneity), and the odds ratios (95% CIs) were 1.23 (0.76-2.02) in patients with eGFR <60 mL/min per 1.73 m2, 0.94 (0.75-1.19) in patients with eGFR values of 60-89 mL/min per 1.73 m2, and 1.04 (0.88-1.24) in patients with eGFR ≥90 mL/min per 1.73 m2, respectively. In addition, early antihypertensive treatment was not associated with secondary clinical outcomes by baseline renal function (P>0.05 for all homogeneity).
Conclusions:
Early antihypertensive treatment had a neutral effect on clinical outcomes in ischemic stroke patients with different renal function status.
Registration:
URL: https://www.
Clinicaltrials:
gov; Unique Identifier: NCT01840072.
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