Rapid Blood-Pressure Lowering in Patients With Acute Intracerebral Hemorrhage

Anderson, Craig S.; Heeley, Emma; Huang, Yining; Wang, Ji‐Guang; Stapf, Christian; Delcourt, Candice; Lindley, Richard I; Robinson, Thompson; Lavados, Pablo M.; Neal, Bruce; Hata, Jun; Arima, Hisatomi; Li, Yuechun; Wang, Jinchao; Héritier, Stéphane; Li, Qiang; Woodward, Mark; Simes, R. J.; Davis, Stephen M.; Chalmers, John

doi:10.1097/01.sa.0000440999.12291.ab

Cited by 65 publications

(86 citation statements)

References 11 publications

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“…The threshold systolic blood pressure of 180 mmHg was the recommended goal at the time these data were collected. These data compare favorably, however, to time to correction of SBP in both INTERACT trials and are similar to ATACH data, albeit with different goals [23,32]. We also did not assess BP reduction or hematoma expansion after the first 24 h. It is possible that some reduction in death and disability may be related to blood pressure control after 24 h although hematoma expansion after this time is not common [33].…”

Section: Discussionsupporting

confidence: 74%

Early Therapy Intensity Level (TIL) Predicts Mortality in Spontaneous Intracerebral Hemorrhage

et al. 2015

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Section: Discussionsupporting

confidence: 74%

Early Therapy Intensity Level (TIL) Predicts Mortality in Spontaneous Intracerebral Hemorrhage

et al. 2015

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“…Similarly, in ICH patients initial promise for rapid BP lowering to SBP targets of <140 mmHg have not been confirmed in subsequent clinical trials. Nevertheless, acute BP lowering to lower targets in the ICH population does appear to be safe [58][59][60].…”

Section: Common Inpatient Conditions Associated With Hypertensionmentioning

confidence: 99%

An Update on Inpatient Hypertension Management

2015

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Hypertension is highly prevalent affecting nearly one third of the US adult population. Though generally approached as an outpatient disorder, elevated blood pressure is observed in a majority of hospitalized patients. The spectrum of hypertensive disease ranges from patients with hypertensive emergency including markedly elevated blood pressure and associated end-organ damage to asymptomatic patients with minimally elevated pressures of unclear significance. It is important to note that current evidence-based hypertension guidelines do not specifically address inpatient hypertension. This narrative review focuses primarily on best practices for diagnosing and managing nonemergent hypertension in the inpatient setting. We describe examples of common hypertensive syndromes, provide suggestions for optimal post-acute management, and point to evidence-based or consensus guidelines where available. In addition, we describe a practical approach to managing asymptomatic elevated blood pressure observed in the inpatient setting. Finally, arranging effective care transitions to ensure optimal ongoing hypertension management is appropriate in all cases.

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“…Two pilot randomized clinical trials, INTERACT and ATACH, suggested that acutely lowering systolic blood pressure to below 140 mmHg is safe [23,24]. INTERACT2 was a phase III clinical trial of acute blood pressure lowering in ICH patients presenting with a systolic blood pressure between 150 and 220 mmHg [25]. Patients were randomized to two different blood pressure thresholds: a standard threshold of <180 mmHg and an intensive threshold of less than 140 mmHg.…”

Section: Blood Pressurementioning

confidence: 99%

Emergency Neurological Life Support: Intracerebral Hemorrhage

et al. 2015

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Intracerebral hemorrhage (ICH) is a subset of stroke due to bleeding within the parenchyma of the brain. It is potentially lethal, and survival depends on ensuring an adequate airway, reversal of coagulopathy, and proper diagnosis. ICH was chosen as an Emergency Neurological Life Support protocol because intervention within the first critical hour may improve outcome, and it is critical to have site-specific protocols to drive care quickly and efficiently.

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Rapid Blood-Pressure Lowering in Patients With Acute Intracerebral Hemorrhage

Cited by 65 publications

References 11 publications

Early Therapy Intensity Level (TIL) Predicts Mortality in Spontaneous Intracerebral Hemorrhage

Early Therapy Intensity Level (TIL) Predicts Mortality in Spontaneous Intracerebral Hemorrhage

An Update on Inpatient Hypertension Management

Emergency Neurological Life Support: Intracerebral Hemorrhage

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