Some blood pressure medications may reduce the risk of an aneurysm rupturing in people with high blood pressure

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A multicenter study of more than 3,000 people with high blood pressure and brain aneurysms found that use of RAAS inhibitors, a class of blood pressure lowering drugs, reduced the risk of aneurysm rupture by 18%, according to new research published today. in Hypertension magazine.

An aneurysm is a bulge or weakness in the wall of an artery. When this happens in one of the arteries in the brain, it is called Intracranial aneurysm. If an intracranial aneurysm ruptures, it spills the blood around the brain and cuts off oxygen to the affected area, which can cause inflammation hemorrhagic strokecoma and death. These strokes account for 3-5% of all strokes, but account for a greater proportion of morbidity and mortality than other types of stroke. Almost every year 30,000 adults in the United States suffer from intracranial aneurysms that are rupturing, according to the National Institute of Neurological Disorders and Stroke. In addition, stroke is a leading cause of disability in the United States.

The renin-angiotensin-aldosterone system (RAAS) in the body includes hormones that affect regulating blood pressureand dysregulation of the RAAS can lead to the development of high blood pressure. Two components of the RAAS have been shown to be involved in the development of intracranial aneurysms, and previous research has found that dysregulation of the RAAS may also contribute to aneurysm rupture. RAAS inhibitors, which are medications that block the effects of the RAAS, are often used to treat hypertension the pressure.

“Almost half of patients with intracranial aneurysms have high blood pressure, which can cause vasculitis and increase the risk of aneurysm rupture,” said senior study author Qinghai Huang, PhD, professor of neurosurgery at Changhai Second Hospital. bloody.” Military Medicine University of Shanghai, China. “Given that a third of patients with a ruptured aneurysm die and another third remain dependent on activities of daily living, there is a need to identify modifiable risk factors to prevent aneurysm rupture.”

This multicenter study analyzed data collected from 2016 to 2021 at 20 medical centers in different regions across China, and collected before and after the rupture, to assess the association between use of RAAS inhibitors and other blood pressure medications, including beta-blockers. and diuretics for the risk of ruptured blood vessels.

More than 3000 adults with hypertension and intracranial aneurysm were included. The study sample was one-third of men and two-thirds of women, with a mean age of 61 years. The participants’ hypertension status was categorized as controlled (normal blood pressure with antihypertensive medication) or uncontrolled (hypertension, defined as 140/90 or higher, with antihypertensive medication), and determined by measurements of blood pressure. Blood taken sometime, three months before they were admitted to the hospital due to an aneurysm.

The analysis found that 32% of participants who took RAAS inhibitors experienced a ruptured intracranial aneurysm, compared to 67% of those who used non-RAAS inhibitors.

“We were surprised to find that even among people with controlled hypertension, those who took RAAS inhibitors still had a significantly lower risk of rupture than individuals who used non-RAAS inhibitors. Our study highlights that using appropriate antihypertensive medications to achieve Balancing blood pressure may significantly reduce the risk of aneurysm rupture.”

“Based on these data, we estimate that approximately 18% of ruptured aneurysms could be prevented if all patients with hypertension and intracranial aneurysms were prescribed RAAS inhibitors. Given the strong potential benefit and high safety of RAAS inhibitors. They also help Doctors are improving treatment to help people with high blood pressure prevent ruptured aneurysms.”

Using a multivariate model, the researchers calculated that women’s risk of aneurysm rupture was 1.8 times higher than that of men’s, and that the following factors increase the risk of aneurysm rupture:

  • Uncontrolled high blood pressure
  • exposure to Passive smoking; And the
  • Untreated type 2 diabetes.

“These findings confirm previous studies that suggest that in addition to controlling blood pressure, smoking cessation and intensive treatment for type 2 diabetes may also help reduce the risk of aneurysm rupture,” Huang said. “However, more research is needed to understand how RAAS inhibitors may be involved in preventing intracranial aneurysm rupture in adults with hypertension.

The authors note that limitations include the retrospective nature of the study, the presence of potential confounding factors, that hypertension was defined as a blood pressure of 140/90, rather than 130/80, that the exact value of the participants’ blood pressure was not taken, and that the duration and dose of RAAS inhibitors It is not registered in the database.


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more information:
The effect of inhibitors of the renin-angiotensin-aldosterone system on the risk of rupture among hypertensive patients with intracranial aneurysms, Hypertension (2022). DOI: 10.1161 / HYPERTENSIONAHA.122.18970

the quote: Certain blood pressure medications may reduce the risk of aneurysm rupture in people with high blood pressure (2022, June 3) Retrieved on June 3, 2022 from https://medicalxpress.com/news/2022-06-blood-pressure -medicine-decrease-dilation of blood vessels

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