Preventing stroke with existing medications
Existing drugs appear to be able to lower the risk of brain hemorrhage caused by a ruptured brain aneurysm. This is what researchers from UMC Utrecht write in a scientific article published in the journal Neurology. Although the results do not prove that these drugs actually reduce the risk, they do show a promising link.
Existing drugs appear to be able to lower the risk of brain hemorrhage caused by a ruptured brain aneurysm. This is what researchers from UMC Utrecht write in a scientific article published in the journal Neurology. Although the results do not prove that these drugs actually reduce the risk, they do show a promising link.
Every year, about 1,500 people suffer a subarachnoid hemorrhage (SAB). That's bleeding in meninges between the brain and skull. This type of stroke occurs because a weak spot in the wall of an artery (aneurysm) bursts open. When an aneurysm bursts, a lot of blood leaks into the brain which often has serious consequences. About one-third of patients die. Of those who survive, a large proportion have permanent brain damage and do not return to their former selves.
"We urgently need new methods to prevent this type of stroke, because it occurs more often in younger people and has a higher mortality rate than other strokes," said lead author Jos Kanning, of UMC Utrecht, the Netherlands. "Our current surgical treatments for brain aneurysms often have more risks of permanent disability and death than benefits. It would therefore be very beneficial if we could use a drug to prevent an aneurysm from bursting."
Existing drugs potentially lower stroke risk
In the study, Jos and his colleagues, including Professor Ynte Ruigrok, looked at data from about 5,000 people who had had a burst brain aneurysm. They compared them with nearly 44,000 people of the same age and gender who had not experienced it. Then the researchers looked at electronic medical records to see what prescription medications people were taking. The study found that four medications were associated with a lower risk of a burst brain aneurysm: a blood pressure-lowering drug (lisinopril), a cholesterol-lowering drug (simvastatin), a diabetes drug (metformin) and a drug for an enlarged prostate (tamsulosin).
The researchers found that people who took lisinopril were 37% less likely to have a burst brain aneurysm. Stroke risk was 22% lower for simvastatin users, 42% lower for metformin users and as much as 45% lower for tamsulosin users. This was after the researchers took into account known SAB risk factors such as high blood pressure, smoking, alcohol consumption and other health problems.
Other drugs actually increase stroke risk
The researchers also found an increased risk of a burst brain aneurysm in people who were taking four other medications. These medications are: the blood thinner warfarin, the anti-depression drug venlafaxine, the anti-psychosis and nausea drug prochlorperazine, and the painkiller co-codamol. But because SAB is so rare, the actual chance of it happening remains very low.
Next steps
It is still difficult to say why these drugs might increase or decrease the risk of SAB. This is because it is unclear whether, for example, it is due to the drug itself or to the condition for which people are taking the drug. To address this problem, Jos and his colleagues are conducting follow-up research. ''We are now working to find out more about lisinopril. We are doing this by looking only at users who already have elevated blood pressure, paying attention to other reasons why people take this drug. We will also look at the dosage of the medication and how long someone has been taking the medication.'' With this new study, Jos and his team hope to better prove that there is a link between the medication and stroke risk.
Source: UMC Utrecht
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