A new study has found that certain blood pressure medications may do more than simply lower blood pressure.
Researchers say these drugs could also help protect people from dangerous brain aneurysm ruptures, potentially reducing the risk of life-threatening bleeding in the brain.
The study was published in the medical journal Hypertension and focused on a group of medications called RAAS inhibitors.
Scientists discovered that people with high blood pressure and brain aneurysms who took these medications had a significantly lower risk of aneurysm rupture compared to people using other blood pressure drugs.
A brain aneurysm, also known as an intracranial aneurysm, is a weak or bulging area in a blood vessel inside the brain. Over time, pressure from blood flow can cause the weakened section of the blood vessel wall to stretch outward like a balloon.
Many brain aneurysms never cause symptoms and may remain unnoticed for years. However, if an aneurysm bursts, it can cause bleeding in the brain known as a hemorrhagic stroke. This type of stroke is extremely serious and often life-threatening.
Every year in the United States, around 30,000 adults experience ruptured brain aneurysms. Although hemorrhagic strokes are less common than other types of strokes, they are often far more deadly and can lead to severe disability, coma, or death.
High blood pressure is considered one of the major risk factors for aneurysm rupture because it places extra stress on blood vessel walls. Doctors have long believed that controlling blood pressure is one of the best ways to lower rupture risk.
In the new study, researchers wanted to determine whether some blood pressure medications might offer additional protection beyond simply lowering blood pressure numbers.
The research team was led by Dr. Qinghai Huang from Changhai Hospital in Shanghai, China. The scientists analyzed medical data from more than 3,000 adults with both high blood pressure and brain aneurysms. The data was collected between 2016 and 2021 from 20 hospitals located across different regions of China.
About two-thirds of the participants were women, and the average age was 61 years old.
The researchers compared patients taking RAAS inhibitors with patients using other common blood pressure medications such as beta-blockers and diuretics.
RAAS inhibitors work by blocking parts of the renin-angiotensin-aldosterone system, often shortened to RAAS. This system helps regulate blood pressure, fluid balance, and blood vessel function inside the body.
When the RAAS system becomes overactive, it can contribute to high blood pressure and may damage blood vessels over time. Scientists believe this imbalance could also increase the likelihood of aneurysm formation or rupture.
The study results were striking.
Among patients taking RAAS inhibitors, about 32% experienced aneurysm rupture. In contrast, about 67% of patients using other blood pressure medications experienced rupture.
Even after accounting for blood pressure control, the protective effect of RAAS inhibitors remained.
This surprised the researchers because it suggested the medications may provide benefits beyond simply lowering blood pressure.
Dr. Huang explained that even among patients whose blood pressure was considered well controlled, those taking RAAS inhibitors still had a lower risk of aneurysm rupture compared to patients using other drugs.
The researchers estimated that nearly 18% of aneurysm ruptures might potentially be prevented if all patients with high blood pressure and brain aneurysms were treated with RAAS inhibitors.
The scientists noted that these medications are already widely used and are generally considered safe for many patients. This means doctors may eventually be able to use existing medications more strategically to lower aneurysm risks.
The study also identified several other important risk factors linked to aneurysm rupture.
Women were found to have about 1.8 times higher risk than men. Additional risk factors included uncontrolled high blood pressure, exposure to second-hand smoke, and untreated Type 2 diabetes.
The findings support earlier research suggesting that overall cardiovascular health plays a major role in protecting blood vessels in the brain.
Researchers emphasized that managing blood pressure carefully, avoiding smoking exposure, and controlling diabetes may all help lower the chances of a dangerous aneurysm rupture.
Although the results are promising, the scientists cautioned that the study has limitations.
The research was retrospective, meaning it examined previously collected medical records rather than following patients prospectively in a controlled experiment. Because of this, the study cannot fully prove that RAAS inhibitors directly caused the lower rupture risk.
The researchers also did not record detailed information such as exact blood pressure readings over time or how long patients had been taking the medications.
In addition, the study used an older definition of high blood pressure based on readings of 140/90 mmHg rather than the newer guideline of 130/80 mmHg used in many countries today.
Even with these limitations, experts say the findings are important because they suggest medication choice may matter when treating patients with both hypertension and brain aneurysms.
More studies will still be needed to confirm the results and determine whether certain RAAS inhibitors work better than others. Future research may also explore exactly how these medications protect blood vessels inside the brain.
For now, the study provides new hope that existing blood pressure medications could help reduce the risk of one of the most dangerous types of stroke.
If future research confirms the findings, doctors may eventually adjust treatment strategies to better protect patients at risk of aneurysm rupture and improve long-term outcomes.
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