Aim for a Happy Medium When Lowering Blood Pressure After Acute Intracerebral Hemorrhage

In the ATACH-2 trial, a blood pressure goal of <140 mm Hg did not improve outcomes compared with a goal of <180 mm Hg.

Acutely elevated blood pressure is associated with worse outcomes after intracerebral hemorrhage (ICH). On the basis of observational data, the 2010 American Heart Association (AHA) guidelines recommended a systolic blood pressure (SBP) target of 160 mm Hg in ICH (Stroke 2010; 41:2108). In 2013, INTERACT 2 investigators reported a strong trend toward better outcomes with an SBP target of <140 mm Hg compared with <180 mm Hg (P = 0.06) (NEJM JW Neurol Aug 2013 and N Engl J Med 2013; 368:2355). The 2015 AHA guidelines stated that a target of 140 mm Hg is safe and can be effective for improving functional outcomes (NEJM JW Neurol Aug 2015 and Stroke 2015; 46:2032). Investigators now report another large, multicenter, randomized trial of acute b…

Reviewing Author

Hooman Kamel, MD

Disclosures

Speaker’s bureauGenentech

Grant / Research supportNational Institutes of Health/National Institute of Neurological Disorders and Stroke; Michael Goldberg Stroke Research Fund

Editorial boardsPLOS One; Scientific Reports

Leadership positions in professional societiesNeurocritical Care Society (Research Committee Member)

Hooman Kamel, MD

Disclosures

Speaker’s bureauGenentech

Grant / Research supportNational Institutes of Health/National Institute of Neurological Disorders and Stroke; Michael Goldberg Stroke Research Fund

Editorial boardsPLOS One; Scientific Reports

Leadership positions in professional societiesNeurocritical Care Society (Research Committee Member)

Aim for a Happy Medium When Lowering Blood Pressure After Acute Intracerebral Hemorrhage

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Reviewing Author