Comparison of Esmolol and Nicardipine treatment in hypertensive acute ıschemic stroke patients

The most important risk factor in ischaemic stroke patients is hypertension (HT). Blood pressure regulation has an important role in hypertensive acute ischaemic stroke patients (AIS). In this study, we planned to compare the efficacy of nicardipine and esmolol infusion on blood pressure control and clinical outcome in hypertensive AIS patients. The study is a retrospective, cross-sectional study. It includes hypertensive AIS patients admitted to the emergency department. Target blood pressure, time to reach target blood pressure, discharge modified Rankin Scale (mRS), intracranial haemorrhage according to The European Cooperative Acute Stroke Study (ECASS II) and 30-day mortality of patients who were started Nicardipine or Esmolol within the indication were determined and mortality and morbidity of the two groups were compared. The study included 82 acute ischaemic stroke patients who were hypertensive at presentation. The mean age of the patients was 72 years (39-93). No difference was observed between the Nicardipine (n = 40) and Esmolol (n = 42) groups in terms of sociodemographic data, vital functions and clinical status (National Institutes of Health Stroke Scale - NIHSS) at admission. The target blood pressure levels were reached faster and more effectively in the Nicardipine group than in the Esmolol group (p < 0.001). No difference was observed between the two groups in terms of mRS, ECASS II scores and 30-day mortality. Nicardipine is more effective than Esmolol in blood pressure control in AIS patients who are candidates for invasive procedures such as thrombolysis and thrombectomy. The fact that there is no difference in mortality and morbidity between the two drugs suggests that Esmolol can also be used in selected patients.