Does Intensive Blood Pressure Lowering for Spontaneous Intracerebral Hemorrhage Increase Ischemic Lesions?

Brain MRI scans performed soon after spontaneous intracerebral hemorrhage (ICH) often show small diffusion-weighted imaging (DWI) lesions consistent with small ischemic infarcts. Lowering acute blood pressure (BP) improves functional outcomes after intracerebral hemorrhage, but whether it might also contribute to the development or extension of these DWI lesions is unclear. To find out, investigators randomized 162 patients with recent ICH symptom onset and a baseline systolic blood pressure (SBP) >140 mm Hg to undergo SBP reduction to a target of <140 mm Hg or <180 mm Hg.

The study was halted at 60% of planned enrollment due to lack of clinical equipoise after data from another trial, INTERACT3, were published. The analysis was limited to 7…