Preventing effect of angiotensin-receptor-blocker for moderate to severe cerebral vasospasm after aneurysmal subarachnoid hemorrhage.

Purpose To verify the effectiveness of angiotensin-receptor blockers (ARBs) in preventing moderate to severe cerebral vasospasm, which may influence patient outcomes in cases of subarachnoid hemorrhage resulting from aneurysmal rupture. Methods Between 2016 and 2020, we treated a total of 210 patients. We obtained the clinical and radiological characteristics of patients through medical records and divided them into two groups: those who were administered ARBs (ARB group) and those who were not (no ARB group). Results One hundred eighty-one patients enrolled in this study. ARB group were 29 and no ARB group were 152. The overall incidence of moderate to severe vasospasm was 33.7%. The incidence of moderate to severe vasospasm in each group was 13.8% (4 patients) and 37.5% (57 patients), respectively. The independent risk factors for moderate to severe vasospasm included Fisher grade (III-IV) with an odds ratio (OR) of 2.732 (95% confidence interval [CI]: 1.343–5.560; P = 0.006), older age (OR = 0.963; 95% CI: 0.938–0.989; P = 0.006), and ARB administration (OR = 0.246; 95% CI: 0.079–0.771; P = 0.016). Conclusions Despite the potential adverse impacts associated with hypotension, the administration of ARBs may provide therapeutic benefits in preventing moderate to severe vasospasm. Age and volume of hemorrhage should be taken into consideration because of their association with the development of moderate to severe cerebral vasospasm.