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Effect of nitric oxide donors on blood pressure and pulse pressure in acute and subacute stroke

Gray, Laura J.; Sprigg, Nikola; Rashid, Parveen; Willmot, Mark; Bath, Philip M.W.

Authors

Laura J. Gray

Nikola Sprigg

Parveen Rashid

Mark Willmot

Philip M.W. Bath



Abstract

High blood pressure (BP), pulse pressure (PP), and rate pressure product (RPP) areeach associated independently with a poor outcome in acute ischemic stroke.
Whereas nitric oxide (NO) donors, such as glyceryl trinitrate (GTN), lower blood pressure in acute ischemic stroke, their effect on other hemodynamic measures is not known. We performed a systematic review of the effects of NO donors on systemic hemodynamic measures in patients with acute/subacute stroke. Randomized controlled trials were identified from searches of the Cochrane Library, Pubmed, and Embase. Information on hemodynamic measures, including systolic BP (SBP), diastolic BP (DBP), and heart rate, were assessed, and hemodynamic derivatives of these were calculated: PP (PP SBP DBP), mean arterial pressure (MAP DBP PP/3), mid blood pressure (MBP (SBP DBP)/2), pulse pressure index (PPI PP/MAP), and RPP (RPP SBP HR). The effect of treatment on hemodynamic measures was calculated as the weighted mean difference (WMD) between treated and control groups with adjustment for baseline.
Results: Three trials involving 145 patients were identified; 93 patients received the NO donor, GTN, and 52 control. As compared with placebo, GTN significantly reduced SBP (WMD -9.80 mmHg, p< 0.001), DBP (WMD -4.43 mmHg, p

Journal Article Type Article
Publication Date Nov 1, 2006
Journal Journal of Stroke and Cerebrovascular Disease
Print ISSN 1052-3057
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 15
Issue 6
APA6 Citation Gray, L. J., Sprigg, N., Rashid, P., Willmot, M., & Bath, P. M. (2006). Effect of nitric oxide donors on blood pressure and pulse pressure in acute and subacute stroke. Journal of Stroke and Cerebrovascular Diseases, 15(6),
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf





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