Allopurinol and blood pressure variability following ischemic stroke and transient ischemic attack: a secondary analysis of XILO-FIST.
Journal: Journal of human hypertension
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Affiliated Institutions:
School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
Robertson Centre for Biostatistics, School of Health and Wellbeing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, G QQ, UK.
DD Analytics Cubed Ltd, Union Street, Greenock, Scotland, PA BG, UK.
Stroke Trials Unit, Mental Health & Clinical Neuroscience, University of Nottingham, Nottingham, NG UH, UK.
Department of Neuroradiology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Govan Road, Glasgow, G TF, UK.
School of Cardiovascular and Metabolic Health, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK.
Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, NR TJ, UK.
Department of Neurology, Institute of Neurological Sciences Glasgow, Queen Elizabeth University Hospital, Govan Road, Glasgow, G TF, UK.
Medicine Monitoring Unit (MEMO), School of Medicine, University of Dundee. Ninewells Hospital, Dundee, DD SY, UK.
School of Psychology & Neuroscience, College of Medical, Veterinary & Life Sciences, University of Glasgow, Queen Elizabeth University Hospital, Glasgow, G TF, UK.
Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK.
University Department of Stroke Care, University Hospital Monklands, Airdrie, ML OJS, UK.
Department of Stroke, Ageing and Health, Guy's and St Thomas NHS Foundation Trust, St Thomas' Hospital, Lambeth Palace Rd, London, SE EH, UK.
School of Cardiovascular and Metabolic Health, College of Medical, Veterinary & Life Sciences, University of Glasgow, Queen Elizabeth University Hospital, Glasgow, G TF, UK.
Department of Stroke Medicine, Mid and South Essex University Hospitals Group, Southend University Hospital, Prittlewell Chase, Westcliff-on-Sea, Essex, SS RY, UK.
Department of Neurology, Leeds General Infirmary, Leeds, UK.
The University of Leeds, Leeds, UK.
Department of Medicine, Southwest Acute Hospital, Enniskillen, BT DN, UK.
Department of Stroke Medicine, The Luton and Dunstable University Hospital, Bedfordshire, NHSFT, Lewsey Road, Luton, LU DZ, UK.
Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK.
Department of Neurology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Department of Stroke Medicine, Royal United Hospital, Combe Park, Bath, BA NG, UK.
Department of Stroke Medicine, Nottingham University Hospitals, Nottingham, NG PB, UK.
Stroke Research Centre, UCL Queen Square Institute of Neurology, London, UK.
School of Cardiovascular and Metabolic Health, College of Medical, Veterinary & Life Sciences, University of Glasgow, Queen Elizabeth University Hospital, Glasgow, G TF, UK. Jesse.Dawson@glasgow.ac.uk.
Abstract summary
Blood Pressure Variability (BPV) is associated with cardiovascular risk and serum uric acid level. We investigated whether BPV was lowered by allopurinol and whether it was related to neuroimaging markers of cerebral small vessel disease (CSVD) and cognition. We used data from a randomised, double-blind, placebo-controlled trial of two years allopurinol treatment after recent ischemic stroke or transient ischemic attack. Visit-to-visit BPV was assessed using brachial blood pressure (BP) recordings. Short-term BPV was assessed using ambulatory BP monitoring (ABPM) performed at 4 weeks and 2 years. Brain MRI was performed at baseline and 2 years. BPV measures were compared between the allopurinol and placebo groups, and with CSVD and cognition. 409 participants (205 allopurinol; 204 placebo) were included in the visit-to-visit BPV analyses. There were no significant differences found between placebo and allopurinol groups for any measure of visit-to-visit BPV. 196 participants were included in analyses of short-term BPV at week 4. Two measures were reduced by allopurinol: the standard deviation (SD) of systolic BP (by 1.30 mmHg (95% confidence interval (CI) 0.18-2.42, p = 0.023)); and the average real variability (ARV) of systolic BP (by 1.31 mmHg (95% CI 0.31-2.32, p = 0.011)). There were no differences in other measures at week 4 or in any measure at 2 years, and BPV was not associated with CSVD or cognition. Allopurinol treatment did not affect visit-to-visit BPV in people with recent ischemic stroke or TIA. Two BPV measures were reduced at week 4 by allopurinol but not at 2 years.
Authors & Co-authors:
Macdonald
McConnachie
Dickie
Bath
Forbes
Quinn
Broomfield
Dani
Doney
Muir
Struthers
Walters
Barber
Bhalla
Cameron
Guyler
Hassan
Kearney
Keegan
Lakshmanan
Macleod
Randall
Shaw
Subramanian
Werring
Dawson
Study Outcome
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