Possible association of beta-blockers use with risk of intracranial aneurysm rupture.

INTRODUCTION: Aneurysmal subarachnoid hemorrhage is a devastating type of stroke, associated with high mortality and morbidity. One of modifiable risk factors of aneurysm rupture is hypertension, however it is still not clear whether any particular anti-hypertensive drugs play a significant role in prevention of aneurysm rupture.

OBJECTIVES: We decided to analyse whether there is any association between the class of commonly used vasoactive medications and risk of intracranial aneurysm rupture.

PATIENTS AND METHODS: We retrospectively analysed 334 patients with ruptured and unruptured intracranial aneurysm.  Based on logistic regression models, we obtained unadjusted and adjusted odds ratios of subarachnoid hemorrhage associated with use of vasoactive medications and with indices of tortuosity.

RESULTS: We found that beta-blockers intake was significantly related with higher tortuosity of cerebral arteries. Also, intake of beta-blockers (OR = 0.41; 95%CI: 0.21 - 0.77; P = 0.01) and statins (OR = 0.23; 95%CI: 0.05 - 0.68; P = 0.01) significantly decreased risk of aneurysm rupture, a result driven by the decreased rupture risk of anterior circulation aneurysms. No such association was found for posterior part of cerebral circulation.

CONCLUSIONS: Aneurysm located in anterior cerebral circulation might be less likely to rupture if patients are receiving beta-blockers or statins.