CATIS-2
Trial question
What is the role of early antihypertensive treatment in patients with AIS?
Study design
Multi-center
Single blinded
RCT
Population
4802 patients.
Inclusion criteria: patients with AIS within 24-48 hours of symptom onset and elevated SBP.
Key exclusion criteria: hemorrhagic stroke; VM, tumor, abscess, or other major nonischemic brain disease; extracranial or intracranial artery stenosis; stroke caused by arteritis, migraine, vasospasm, or substance abuse; severe stroke; coma; preceding moderate or severe dependency.
Interventions
N=2408 early antihypertensive treatment (BP-lowering treatment initiated immediately after randomization).
N=2394 delayed antihypertensive treatment (antihypertensive medications discontinued in the first 7 days after randomization and then initiated on day 8).
Primary outcome
Death or functional dependency at day 90 in patients with hypertension
11.8%
10.7%
11.8 %
8.9 %
5.9 %
3.0 %
0.0 %
Early antihypertensive
treatment
Delayed antihypertensive
treatment
No significant
difference ↔
No significant difference in death or functional dependency at day 90 in patients with hypertension (11.8% vs. 10.7%; OR 1.11, 95% CI 0.91 to 1.36).
Secondary outcomes
No significant difference in death or functional dependency at day 90 in patients without hypertension (13% vs. 9.6%; OR 1.38, 95% CI 0.92 to 2.08).
Conclusion
In patients with AIS within 24-48 hours of symptom onset and elevated SBP, early antihypertensive treatment was not superior to delayed antihypertensive treatment with respect to death or functional dependency at day 90 in patients with hypertension.
Reference
Xuewei Xie, Chongke Zhong, Xin Liu et al. Early Versus Delayed Antihypertensive Treatment After Acute Ischemic Stroke by Hypertension History. Stroke. 2025 Mar;56(3):631-639.
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