Degree and Timing of Intensive Blood Pressure Lowering on Hematoma Growth in Intracerebral Hemorrhage: Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial-2 Results

Cheryl Carcel, Xia Wang, Shoichiro Sato, Christian Stapf, Else Charlotte Sandset, Candice Delcourt, Hisatomi Arima, Thompson Robinson, Pablo Lavados, John Chalmers, Craig S. Anderson

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background and Purpose - Degree and timing of blood pressure (BP) lowering treatment in relation to hematoma growth were investigated in the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial-2 (INTERACT2). Methods - INTERACT2 was an international clinical trial of intensive (target systolic BP [SBP], <140 mm Hg) versus guideline-recommended (SBP, <180 mm Hg) BP lowering in 2839 patients within 6 hours of spontaneous intracerebral hemorrhage and elevated SBP (150-220 mm Hg), in which 964 had repeat cranial computed tomography at 24 hours. ANCOVA models assessed categories of SBP reduction and time to target SBP on 24-hour hematoma growth. Results - Greater SBP reduction was associated with reduced hematoma growth (13.3, 5.0, and 3.0 mL for <10, 10-20, and ≥20 mm Hg, respectively; P trend<0.001). In the intensive treatment group (n=491), the least mean hematoma growth was in patients who achieved target SBP <1 hour (2.6 mL) versus to those in target at 1 to 6 (4.7 mL) and >6 hours (5.4 mL). The smallest mean absolute hematoma growth (2.0 mL) was in those achieving target SBP 5 to 8 times versus 3 to 4 (3.1 mL) and 0 to 2 times (5.2 mL). Conclusions - Intensive BP lowering with greater SBP reduction, which is achieved quickly and maintained consistently, seems to provide protection against hematoma growth for 24 hours. Clinical Trial Registration - URL: http://www.clinicaltrials.gov. Unique identifier: NCT00716079.

Original languageEnglish
Pages (from-to)1651-1653
Number of pages3
JournalStroke
Volume47
Issue number6
DOIs
Publication statusPublished - 3 May 2016
Externally publishedYes

Keywords

  • blood pressure
  • cerebral hemorrhage
  • hematoma
  • tomography

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