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ACCESS
Acute Candesartan Cilexetil Evaluation in Stroke Survivors
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Author(s) |
Schrader J, Lüders S, Kollmann K, Kulschewski A, Berger J, Zidek W, Treib J, Einhäupl K, Diener HC, Dominiak P
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Title(s) |
The ACCESS Study. Evaluation of acute candesartan cilexetil therapy in stroke survivors |
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Reference(s) |
Stroke 2003;34:1699–703 |
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Disease |
Acute ischaemic stroke, severe hypertension
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Purpose |
To evaluate the benefits of moderate but immediate BP reduction in patients with acute stroke and severe hypertension
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Study design |
Randomised, double-blind, placebo-controlled
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Follow-up |
7 days and 1 year
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Patients |
Aim was 5000 patients, aged ≤ 85 years, with acute cerebral ischaemia, motor paresis and severe hypertension (BP > 200/110 mm Hg systolic and/or diastolic on occasional measuring or > 180/105 mm Hg median of 2 measurements in 30 min)
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Treatment regimen |
Candesartan cilexetil, 4-16 mg/day depending on BP, for 7 days and continued if necessary until 1-year follow-up, or placebo. In the placebo group, candesartan was given during the follow-up phase to patients who were still hypertensive at day 7
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Results |
Cumulative 12-month mortality and the number of vascular events differed significantly in favour of the candesartan group (odds ratio, 0.475; 95% CI 0.252–0.895). Data showed that a 7-day course of candesartan after acute stroke significantly improves cardiovascular morbidity and mortality |
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Comments |
The trial was stopped early when 342 patients (339 valid) had been randomised because of an imbalance in endpoints |
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