Preventive Effect of Aggressive Blood Pressure Lowering on Hematoma Enlargement in Patients With Ultra-acute Intracerebral Hemorrhage

Nishikawa, Tomofumi; Ueba, Tetsuya; Kajiwara, Motohiro; Iwata, Ren; Miyamatsu, Naomi; Yamashita, K

doi:10.2176/nmc.50.966

Cited by 6 publications

(2 citation statements)

References 33 publications

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“…Stroke is one of the leading causes of death and disability worldwide. 1 – 3 Decreasing the time from stroke onset to hospital arrival offers the greatest opportunity for effective acute stroke therapy 4 – 8 ; however, delay in hospital presentation of patients with acute stroke still remains substantial. 9 – 12 …”

Section: Introductionmentioning

confidence: 99%

Effects of a Public Education Campaign on the Association Between Knowledge of Early Stroke Symptoms and Intention to Call an Ambulance at Stroke Onset: The Acquisition of Stroke Knowledge (ASK) Study

Nishikawa

Okamura

Nakayama³

et al. 2016

Journal of Epidemiology

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BackgroundAn immediate ambulance call offers the greatest opportunity for acute stroke therapy. Effectively using ambulance services requires strengthening the association between knowledge of early stroke symptoms and intention to call an ambulance at stroke onset, and encouraging the public to use ambulance services.MethodsThe present study utilized data from the Acquisition of Stroke Knowledge (ASK) study, which administered multiple-choice, mail-in surveys regarding awareness of early stroke symptoms and response to a stroke attack before and after a 2-year stroke education campaign in two areas subject to intensive and moderate intervention, as well as in a control area, in Japan. In these three areas, 3833 individuals (1680, 1088 and 1065 participants in intensive intervention, moderate intervention, and control areas, respectively), aged 40 to 74 years, who responded appropriately to each survey were included in the present study.ResultsAfter the intervention, the number of correctly identified symptoms significantly associated with intention to call an ambulance (P < 0.05) increased (eg, from 4 to 5 correctly identified symptoms), without increasing choice of decoy symptoms in the intensive intervention area. Meanwhile, in other areas, rate of identification of not only correct symptoms but also decoy symptoms associated with intention to call an ambulance increased. Furthermore, the association between improvement in the knowledge of stroke symptoms and intention to call an ambulance was observed only in the intensive intervention area (P = 0.009).ConclusionsOur results indicate that intensive interventions are useful for strengthening the association between correct knowledge of early stroke symptoms and intention to call an ambulance, without strengthening the association between incorrect knowledge and intention to call an ambulance.

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Section: Introductionmentioning

confidence: 99%

Effects of a Public Education Campaign on the Association Between Knowledge of Early Stroke Symptoms and Intention to Call an Ambulance at Stroke Onset: The Acquisition of Stroke Knowledge (ASK) Study

Nishikawa

Okamura

Nakayama³

et al. 2016

Journal of Epidemiology

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“…For example, Nishikawa et al demonstrated that early BP treatment to < 140 mm Hg was associated with low rates of hematoma expansion to only 15%. 34 This was complemented by several studies that showed that early treatment of elevated BP was associated with a decrease in mortality and poor outcome. [35][36][37][38][39][40] On the contrary, Qureshi 41 showed that a rapid decline in BP within 24 hours from ICH onset was associated with a rise in mortality.…”

Section: Evidence From Observational and Pilot Studiesmentioning

confidence: 97%

Blood Pressure Management in Intracerebral Hemorrhage

Mohammad

Qureshi

2016

Semin Neurol

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Intracerebral hemorrhage (ICH) is associated with devastating outcomes. Admission to the intensive care unit has been the only proven course to improve outcomes. All other treatment modalities have failed so far. The majority of patients presenting with ICH have an elevated blood pressure (BP). Initial data on the safety and efficacy of BP treatment in acute ICH have been conflicting. This has led to large prospective and randomized clinical trials to assess the safety and efficacy of early BP lowering in acute ICH. These trials showed safety and a tendency toward improved functional outcomes. In fact, the results of three subsequent meta-analyses also showed safety and possible efficacy of early lowering of BP in ICH. Based on the results of the published clinical trials and meta-analyses, the American Heart Association and the European Stroke Association concluded that early intensive treatment of BP in acute ICH is safe and might improve functional outcome. The authors advocate that-pending additional data from ongoing trials-health care professionals should maintain the SBp < 140 mm Hg in patients presenting with acute ICH.

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Influence of baseline systolic blood pressure on the relationship between intensive blood pressure control and cardiovascular outcomes in the Systolic Blood Pressure Intervention Trial (SPRINT)

Sun

Guo

Nie³

et al. 2018

Clin Res Cardiol

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Preventive Effect of Aggressive Blood Pressure Lowering on Hematoma Enlargement in Patients With Ultra-acute Intracerebral Hemorrhage

Cited by 6 publications

References 33 publications

Effects of a Public Education Campaign on the Association Between Knowledge of Early Stroke Symptoms and Intention to Call an Ambulance at Stroke Onset: The Acquisition of Stroke Knowledge (ASK) Study

Effects of a Public Education Campaign on the Association Between Knowledge of Early Stroke Symptoms and Intention to Call an Ambulance at Stroke Onset: The Acquisition of Stroke Knowledge (ASK) Study

Blood Pressure Management in Intracerebral Hemorrhage

Influence of baseline systolic blood pressure on the relationship between intensive blood pressure control and cardiovascular outcomes in the Systolic Blood Pressure Intervention Trial (SPRINT)

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