Document Detail


Lower treatment blood pressure is associated with greatest reduction in hematoma growth after acute intracerebral hemorrhage.
MedLine Citation:
PMID:  20823381     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The pilot phase of the Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT) showed that rapid blood pressure (BP) lowering can attenuate hematoma growth in acute intracerebral hemorrhage. We sought to define the systolic BP level associated with greatest attenuation of hematoma growth. INTERACT included 404 patients with computed tomographic-confirmed intracerebral hemorrhage, elevated systolic BP (150 to 220 mm Hg), and capacity to commence BP lowering treatment within 6 hours of onset. Computed tomography was done at baseline and at 24 hours using standardized techniques, with digital images analyzed centrally, blinded to clinical data. Associations of baseline and achieved on-treatment (mean during the first 24 hours) systolic BP levels with the primary outcome of increase in hematoma volume were explored. There were 346 patients with duplicate computed tomographic scans. There was no significant association between baseline systolic BP levels and either the absolute or proportional growth in hematoma volume (P trend=0.26 and 0.12, respectively). By contrast, achieved on-treatment systolic BP levels in the first 24 hours were clearly associated with both absolute and proportional hematoma growth (both P trend=0.03). Maximum reduction in hematoma growth occurred in the one third of participants with the lowest on-treatment systolic BP levels (median: 135 mm Hg). Intensive BP reduction to systolic levels between 130 and 140 mm Hg is likely to provide the maximum protection against hematoma growth after intracerebral hemorrhage.
Authors:
Hisatomi Arima; Craig S Anderson; Ji Guang Wang; Yining Huang; Emma Heeley; Bruce Neal; Mark Woodward; Christian Skulina; Mark W Parsons; Bin Peng; Qing Ling Tao; Yue Chun Li; Jian Dong Jiang; Li Wen Tai; Jin Li Zhang; En Xu; Yan Cheng; Lewis B Morgenstern; John Chalmers;
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-09-07
Journal Detail:
Title:  Hypertension     Volume:  56     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-21     Completed Date:  2010-11-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  852-8     Citation Subset:  IM    
Affiliation:
George Institute for Global Health, Royal Prince Alfred Hospital and University of Sydney, NSW, Australia.
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00226096
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Analysis of Variance
Antihypertensive Agents / therapeutic use*
Blood Pressure / drug effects*
Cerebral Hemorrhage / drug therapy*,  radiography
Female
Hematoma / drug therapy*,  prevention & control,  radiography
Humans
Hypertension / drug therapy*,  radiography
Male
Middle Aged
Patient Selection
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antihypertensive Agents
Comments/Corrections
Comment In:
Hypertension. 2010 Nov;56(5):808-10   [PMID:  20823376 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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