Could Alpha Blockers Increase Risk of Ischemic Stroke?

Older men starting alpha-blockers have an increased risk of ischemic stroke during the early initiation period as compared to patients who were not taking other antihypertensive agents.

Researchers noted that alpha-blockers were originally designed to control hypertension, but are now used by older men with prostate hypertrophy as they best provide cardiovascular protection as compared to other blood pressure drugs. However, men starting alpha-blockers experience a large drop in blood pressure within the first few treatment doses, which in turn, increases the risk of stroke.
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In the study, researchers looked at 7502 patients (mean age of 71) who had both a first stroke and new prescription of alpha-blockers within the 3-year study period.

“We observed an increased risk of ischemic stroke in the early initiation period (within 21 d after the start of treatment) and a reduced risk in the late initiation period (22-60 d after the start of treatment),” said Chao-Lun Lai, MD, PhD, department of internal medicine and center for critical care medicine at the National Taiwan University Hospital Hsin-Chu Branch in Hsin-Chu, Taiwan.

Men who were not taking any other blood pressure drugs had a 2-fold increased risk of ischemic stroke during the early initiation period. Men who were already taking other blood pressure medications had no increased risk of stroke, which researchers attributed to the individuals being used to the medications and their effect in stabilizing blood pressure.

Further studies are needed to determine whether other ethnicities are also at increased risk of stroke.

The full study is available in the Canadian Medical Association Journal.

—Pooja Shah

Reference:

Lai CL, Kuo RN, Chen HM, et al. Risk of ischemic stroke during the initiation period of α-blocker therapy among older men. CMAJ. 2015 Dec 7 [epub ahead of print] doi: 10.1503/cmaj.150624