The Importance of BP Lowering in Intracerebral Hemorrhage Survivors

Clinical Takeaway

: Intensive BP lowering after ICH lowered recurrent stroke (mainly hemorrhage), without excess adverse events.

Context

For a patient who has had an intracerebral hemorrhage (ICH), blood pressure (BP) lowering is desirable whether or not they had preexisting hypertension. Guidelines from the American Heart Association/American Stroke Association (AHA/ASA) recommend a long-term systolic BP (SBP) target of <130 mm Hg for ICH survivors, but evidence on the benefits of this strategy is limited.

Researchers conducted an individual participant–data meta-analysis from four trials in which patients with ICH were randomly assigned to intensive BP lowering or control (i.e., placebo or usual care). In some trials, the intervention was a specific SBP goal (e.g., 120 mm Hg), whereas in others it was a medication regimen added to standard treatment. About 3000 patie…

Reviewing Author

Seemant Chaturvedi, M.D.

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke