Olmesartan Improves Cerebral Hemodynamic and Neurologic Outcomes in Elderly Patients with Hypertension and Ischemic Stroke

A.V. Savustyanenko

Abstract


Background. In patients with hypertension there is a violation of autoregulation of cerebral hemodynamics. When conducting antihypertensive therapy, it is important to choose such targets for pressure reduction and such antihypertensive agents, which will not impair the blood supply to the brain.
The results of the research. Studies have demonstrated that olmesartan completely restores the cerebral blood flow in elderly patients with hypertension and cerebral hypoperfusion. In contrast to amlodipine, olmesartan increases the cerebral blood flow in the affected (by 15.5 %) and health (by 9.2 %) hemispheres in elderly patients with hypertension and ischemic stroke, increases the value of cerebrovascular reserve in the affected hemisphere (by 55%) in the same group of patients. Due to these effects, more pronounced recovery of neurological function by Brunnstrom scale is observed among patients treated with olmesartan: severity of hemiplegia was decreased by 50 % (in the group with amlodi-pine — by 17.4 %).
Mechanisms. It is assumed that the ability of olmesartan to normalize autoregulation of cerebral circulation is associated with the possessing of anti-inflammatory and antioxidant effects in the wall of the brain arterioles due to direct blockade of the AT1-receptors.
Modes of treatment. Based on current recommendations in most cases olmesartan therapy as any other antihypertensives must begin in a few weeks after the acute phase of ischemic stroke.


Keywords


amlodipine; autoregulation of cerebral blood flow; ischemic stroke; olmesartan

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DOI: https://doi.org/10.22141/2224-1485.5.37.2014.82746

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