Blood Pressure Reduction After Acute Intracerebral Hemorrhage: How Early and How Low?

Intensive lowering of blood pressure did not outperform the standard approach in this limited study of patients with acute intracerebral hemorrhage.

Optimal blood pressure management is challenging in patients with acute intracerebral hemorrhage (ICH). Reducing BP too low can lead to cerebral ischemia from lack of perfusion, while maintaining BP too high can increase the size of the hemorrhage. In a multicenter trial (Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial; INTERACT), researchers in Asia and Australia randomized 404 adults with acute ICH diagnosed by computed tomography (CT) scan within 6 hours of onset and elevated systolic BP (150–220 mm Hg) to intensive BP reduction (target systolic BP, 140 mm Hg) or standard therapy (target systolic BP, 180 mm Hg). Use of antiplatelet and warfarin therapy was similar in the two groups.

After adjustment for initial hemat…

Reviewing Author

Kristi L. Koenig, MD, FACEP