MacDonald, A. S. et al. (2024) Allopurinol and blood pressure variability following ischemic stroke and transient ischemic attack: a secondary analysis of XILO-FIST. Journal of Human Hypertension, (doi: 10.1038/s41371-024-00906-5) (Early Online Publication)
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Abstract
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.
| Item Type: | Articles |
|---|---|
| Additional Information: | XILO-FIST was financially supported by a joint Stroke Association and British Heart Foundation Programme Grant (ref: TSA BHF 2013/01). |
| Status: | Early Online Publication |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Cameron, Dr Alan and Walters, Professor Matthew and Barber, Dr Mark and Dickie, Dr David Alexander and Broomfield, Dr Niall and McConnachie, Professor Alex and Dawson, Professor Jesse and Muir, Professor Keith and Forbes, Dr Kirsten and Quinn, Professor Terry and Dani, Dr Krishna |
| Authors: | MacDonald, A. S., McConnachie, A., Dickie, D. A., Bath, P. M., Forbes, K., Quinn, T., Broomfield, N. M., Dani, K., Doney, A., Muir, K. W., Struthers, A., Walters, M., Barber, M., Bhalla, A., Cameron, A., Guyler, P., Hassan, A., Kearney, M., Keegan, B., Lakshmanan, S., Macleod, M. J., Randall, M., Shaw, L., Subramanian, G., Werring, D., and Dawson, J. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing College of Medical Veterinary and Life Sciences > School of Psychology & Neuroscience |
| Journal Name: | Journal of Human Hypertension |
| Publisher: | Springer Nature |
| ISSN: | 0950-9240 |
| ISSN (Online): | 1476-5527 |
| Published Online: | 04 March 2024 |
| Copyright Holders: | Copyright © 2024 The Authors |
| First Published: | First published in Journal of Human Hypertension 2024 |
| Publisher Policy: | Reproduced under a Creative Commons licence |
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