Efficacy and safety of antihypertensive treatment with the calcium antagonist felodipine in patients with hypertension after acute ischemic stroke

In an open (pilot-) study 16 patients (age 45 - 85 years) with arterial hypertension (office blood pressure > 160/95 mmHg in the supine position) after acute ischemic stroke (duration > 6 hours within the last 14 days) were treated as baseline therapy or add-on therapy with the longacting dihydropyridine calcium antagonist felodipine (5 - 10 mg o.i.d.). Duration of treatment was 12 weeks, target blood pressure was 140 - 160/85 - 95 mmHg. In addition to conventional blood pressure measurements simultaneous registration of ambulatory blood pressure (ABPM) and Holter ECG was performed before treatment and after one week. Office blood pressure was significantly reduced from 166 +/- 11/92 +/- 9 mmHg to 140 +/- 14/82 +/- 9 mmHg (p < 0.01), 24-h ambulatory blood pressure from 144 +/- 14/74 +/- 12 mmHg to 131 +/- 17/66 +/- 9 mmHg (p < 0.01). There was no significant change in heart rate, cardiac arrhythmias, ischemic episodes and the neurological status during treatment with felodipine. Thus, felodipine as mono- or add-on therapy efficiently lowers blood pressure in hypertensive patients after acute ischemic stroke without any negative effects on myocardial ischemia, cardiac arrhythmias and neurological outcome.