A new study has found that certain blood pressure medications may lower the risk of a dangerous brain aneurysm rupture.
Researchers found that medications called RAAS inhibitors reduced the risk of rupture by 18% in people with high blood pressure and brain aneurysms. The findings were published in the journal Hypertension.
A brain aneurysm, also called an intracranial aneurysm, is a bulge or weak spot in a blood vessel in the brain.
If it bursts, it can cause a hemorrhagic stroke, which is often severe and life-threatening.
Each year in the U.S., about 30,000 adults experience ruptured brain aneurysms. These types of strokes are less common but more deadly than other strokes.
The study focused on RAAS inhibitors, a class of medications that lower blood pressure by blocking certain hormones in the body.
These hormones are part of the renin-angiotensin-aldosterone system (RAAS), which helps regulate blood pressure. When RAAS is out of balance, it can contribute to high blood pressure and potentially increase the risk of an aneurysm forming or rupturing.
The research team, led by Dr. Qinghai Huang from Changhai Hospital in Shanghai, China, studied more than 3,000 adults with high blood pressure and brain aneurysms. Data was collected from 2016 to 2021 across 20 hospitals in different regions of China. About two-thirds of the participants were women, and the average age was 61.
The researchers compared patients who were taking RAAS inhibitors to those using other blood pressure medications like beta-blockers or diuretics.
They found that 32% of those taking RAAS inhibitors had an aneurysm rupture, compared to 67% of those on other blood pressure drugs. This difference remained even among people whose blood pressure was considered controlled.
“We were surprised to find that even among those with well-managed blood pressure, people using RAAS inhibitors still had a lower risk of aneurysm rupture,” said Dr. Huang. “This suggests that RAAS inhibitors offer extra protection beyond just lowering blood pressure.”
The researchers estimated that nearly 18% of aneurysm ruptures could be prevented if all patients with high blood pressure and brain aneurysms were treated with RAAS inhibitors. They noted that these medications are generally safe and could help doctors better manage treatment plans for patients at risk.
The study also looked at other risk factors for aneurysm rupture. Women had a 1.8 times higher risk than men. Additional risk factors included:
Uncontrolled high blood pressure
Exposure to second-hand smoke
Untreated Type 2 diabetes
Dr. Huang noted that these results support previous research showing that, in addition to blood pressure control, avoiding smoking and managing diabetes can also help reduce the risk of aneurysm rupture.
While the results are promising, the study does have some limitations. It was retrospective, meaning it looked back at existing data. Also, the researchers didn’t record exact blood pressure readings or how long patients were taking the medications. They also used the older definition of high blood pressure—140/90 instead of the more current 130/80.
Still, the findings suggest that choosing the right blood pressure medication may play a key role in preventing dangerous brain aneurysms from bursting. More research is needed, but this study could help guide better treatment for people with high blood pressure and brain aneurysms.
The study is published in Hypertension.
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