This Article Full Text Full Text (PDF) All Versions of this Article: 34/10/2339    most recent 01.STR.0000090346.45784.C3v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by De Schryver, E.L.L.M. Search for Related Content PubMed PubMed Citation Articles by De Schryver, E.L.L.M. Related Collections Secondary prevention Antiplatelets

(Stroke. 2003;34:2339.)
© 2003 American Heart Association, Inc.

Original Contributions

Dipyridamole in Stroke Prevention

Effect of Dipyridamole on Blood Pressure

E.L.L.M. De Schryver, MD for the ESPRIT Study Group

From the Department of Neurology, University Medical Center Utrecht, the Netherlands.

Correspondence to E.L.L.M. De Schryver, MD, University Medical Center Utrecht, H 02.128, PO Box 85500, 3508 GA Utrecht, Netherlands. E-mail e.deschryver{at}neuro.azu.nl

Background and Purpose— Trial data suggest that dipyridamole, with or without aspirin, is more efficacious in the secondary prevention of stroke than of coronary events. This selective effect might be attributed to blood pressure lowering by dipyridamole. Therefore, we aimed to assess the effect on blood pressure in the setting of a randomized clinical trial in patients with cerebral ischemia of presumed arterial origin.

Methods— In this study, 591 patients with recent cerebral ischemia of arterial origin were randomly allocated to treatment with aspirin 30 to 325 mg/d or with the combination of aspirin and dipyridamole 400 mg/d in the European/Australian Stroke Prevention in Reversible Ischemia Trial. In an on-treatment analysis, the change in blood pressure measurements from baseline to values after at least 6 months of follow up was assessed with linear regression analysis.

Results— After an average period of 15 months, systolic blood pressure dropped 6.2 mm Hg in the aspirin plus dipyridamole group (n=273) and 6.2 mm Hg in the aspirin group (n=318), for a difference of 0.0 mm Hg (95% confidence interval, -3.8 to 3.7). Diastolic blood pressure dropped 3.6 mm Hg in the aspirin plus dipyridamole group compared with 2.7 mm Hg in the aspirin group, for a difference of 0.9 mm Hg (95% confidence interval, -1.0 to 2.9).

Conclusions— It is unlikely that dipyridamole leads to a permanent reduction in blood pressure and that this would explain why this drug might prevent strokes rather than coronary events.

Key Words: blood pressure • dipyridamole • stroke • stroke prevention

This article has been cited by other articles:

				C. Sudlow Dipyridamole with aspirin is better than aspirin alone in preventing vascular events after ischaemic stroke or TIA BMJ, April 28, 2007; 334(7599): 901 - 901. [Full Text] [PDF]

				J. Leonardi-Bee, P. M.W. Bath, M.-G. Bousser, A. Davalos, H.-C. Diener, B. Guiraud-Chaumeil, J. Sivenius, F. Yatsu, M. E. Dewey, and on behalf of the Dipyridamole in Stroke Collaborat Dipyridamole for Preventing Recurrent Ischemic Stroke and Other Vascular Events: A Meta-Analysis of Individual Patient Data From Randomized Controlled Trials Stroke, January 1, 2005; 36(1): 162 - 168. [Abstract] [Full Text] [PDF]