513 Bali Medical Journal 2022; 11(1): 513-519 | doi: 10.15562/bmj.v11i1.2076 ORIGINAL ARTICLE ABSTRACT The efect of antihypertensive monotherapy and combination on blood pressure in stroke patients Ema Pristi Yunita 1* , Safana Qolby Mayana 1 , Zamroni Aff 2 Background: Stroke is a syndrome characterized by loss of focal and function of the rapidly developing CNS. Furthermore, hypertension is a known risk factor that occurs approximately 70% of the time, and lowering systolic BP from 1 to 3 mmHg efectively reduces the risk of stroke by 20 to 30%. Methods: An observational analytic design, using a retrospective medical record data collection in Malang City Hospital. A total of 113 patients met the inclusion criteria. In addition, the inclusion criteria include hospitalized patients with a primary diagnosis of stroke, ischemia or bleeding as evidenced by a head CT scan, having comorbid hypertension, and having received antihypertensive therapy. Meanwhile, the exclusion criteria were the BP data of the patient measured only once. Results: The results showed the ability of antihypertensive monotherapy and combinations to lower systolic BP by 33.62 ± 30.15 mmHg and 30.50 ± 29.47 mmHg (p = 0.744) in ischemic patients. In comparison, diastolic BP decreased by 6.86 ± 13.18 mmHg and 11.50 ± 16.26 mmHg (0.291), respectively. Moreover, the administration in bleeding stroke patients resulted in a decrease to 16.95 ± 17.89 mmHg and 22.82 ± 23.91 mmHg, (p = 0.029) for systolic, and 8.63 ± 14.63 mmHg and 8.71 ± 17.17 mmHg (p = 0.647) for diastolic BP, respectively. Furthermore, a combination of 4 antihypertensives drugs showed a better decrease in systolic BP in both patients (44.50 ± 21.63) compared to monotherapy, and a mixture of 2 as well as three drugs, by 27.02±27.05, 25.65 ± 29.97, and 25.37 ± 25.08 (p = 0.027), respectively. Conclusions: Combination therapy is recommended in stroke patients because BP can be better controlled. Keywords: hypertension, stroke, antihypertensive therapy. Cite This Article: Yunita, E.P., Mayana, S.Q., Aff, Z. 2022. The efect of antihypertensive monotherapy and combination on blood pressure in stroke patients. Bali Medical Journal 11(1): 513-519. DOI: 10.15562/bmj.v11i1.2076 1 Pharmacy study program, Faculty of Medicine, Universitas Brawijaya 2 Neurology Department, Medical Faculty, Brawijaya University, Saiful Anwar General Hospital, Malang, Indonesia. *Corresponding to: Ema Pristi Yunita; Pharmacy study program, Faculty of Medicine, Universitas Brawijaya; emapristi@ub.ac.id Received: 2021-11-15 Accepted: 2022-04-22 Published: 2022-04-30 Bali Medical Journal (Bali MedJ) 2022, Volume 11, Number 1: 513-519 P-ISSN.2089-1180, E-ISSN: 2302-2914 Open access: www.balimedicaljournal.org INTRODUCTION Stroke is a syndrome characterized by the functional loss of the focal and global central nervous system, which is believed to develop rapidly and whose symptoms last longer than 24 hours. Tis disease is fatal and has a high tendency, which might result in death, requiring immediate emergency treatment. Te main cause is a blockage in the blood supply to the brain or a rupture of the vessels, which is believed to disrupt oxygen and nutrients, causing damage to nerve cells, afecting brain function, and developing stroke symptoms. 1-2 Based on anatomic pathology, strokes are classifed into ischemic and bleeding, where the former encompasses brain tissue damages due to poor blood fow. At the same time, the latter is characterized by uncontrolled bleeding, determined to destroy cerebral cells. 3 Hypertension is a risk factor for cardiovascular diseases, including stroke, with an incidence rate of 70%. Furthermore, only 29% of patients receive antihypertensive therapy, while barely 45% experience controlled conditions. 4 Several studies have shown that high systolic and diastolic blood pressure (BP) increases the risk of cardiovascular disease. However, it is known that a 1 to 3 mmHg decrease in systolic BP reduces the relative risk of stroke by 20 to 30%. 5 Antihypertensive therapy helps control BP and prevent recurrent stroke. However, it is important to gradually lower the high values by considering the patient’s special conditions, including the BP value and the type of stroke. Furthermore, the classes of antihypertensive drugs also include Diuretics, Angiotensin-Converting Enzyme Inhibitors (ACEI), Calcium Channel Blockers (CCB), β-Blockers (BB), Angiotensin Receptor Blockers (ARB), α-Blockers, and direct vasodilators. 6 In Indonesia, there is minimal research to evaluate antihypertensives’ use in ischemic and bleeding strokes. Terefore, this research aims to evaluate the use of antihypertensives in ischemic and bleeding stroke patients. Furthermore, numerous stroke treatments require BP monitoring when using antihypertensive to ensure better control through a routine medium. RESEARCH DESIGN AND METHODS Study design and participants An observational design with retrospective data collection was used, including patients with the inclusion and exclusion