Safety and Efficacy of Extreme Blood Pressure Lowering in Intracerebral Hemorrhage

Higher rates of neurologic deterioration and adverse events were associated with intensive treatment in patients with excessively high initial systolic blood pressure.

Many patients with intracerebral hemorrhage (ICH) present with elevated systolic blood pressure (SBP). At times, SBP can be markedly elevated (>220 mm Hg). The clinical consequences of extreme SBP lowering in these patients (to <140 mm Hg) are not clear. In this retrospective analysis of the ATACH 2 clinical trial, investigators randomized 999 patients (SBP, >180 mm Hg; men, 62%) to intensive SBP lowering (target SBP, 110–139 mm Hg) or standard treatment (target SBP, 140–179 mm Hg).

A total of 228 patients presented with an initial SBP greater than 220 mm Hg. In this subgroup, the mean initial SBP was 237 mm Hg, compared with 190 mm Hg in the comparison group. Black individuals were more likely to have SBP ≥220 mm Hg than lower SBP (19% vs. …

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Safety and Efficacy of Extreme Blood Pressure Lowering in Intracerebral Hemorrhage

Topics

Reviewing Author