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Lower Treatment Blood Pressure Is Associated With Greatest Reduction in Hematoma Growth After Acute Intracerebral Hemorrhage

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 h... Full description

Journal Title: Hypertension (Dallas Tex. 1979), 2010-11, Vol.56 (5), p.852-858
Main Author: Arima, Hisatomi
Other Authors: Anderson, Craig S , Wang, Ji Guang , Huang, Yining , Heeley, Emma , Neal, Bruce , Woodward, Mark , Skulina, Christian , Parsons, Mark W , Peng, Bin , Tao, Qing Ling , Li, Yue Chun , Jiang, Jian Dong , Tai, Li Wen , Zhang, Jin Li , Xu, En , Cheng, Yan , Morgenstern, Lewis B , Chalmers, John
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Hagerstown, MD: American Heart Association, Inc
ID: ISSN: 0194-911X
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recordid: cdi_proquest_miscellaneous_760238611
title: Lower Treatment Blood Pressure Is Associated With Greatest Reduction in Hematoma Growth After Acute Intracerebral Hemorrhage
format: Article
creator:
  • Arima, Hisatomi
  • Anderson, Craig S
  • Wang, Ji Guang
  • Huang, Yining
  • Heeley, Emma
  • Neal, Bruce
  • Woodward, Mark
  • Skulina, Christian
  • Parsons, Mark W
  • Peng, Bin
  • Tao, Qing Ling
  • Li, Yue Chun
  • Jiang, Jian Dong
  • Tai, Li Wen
  • Zhang, Jin Li
  • Xu, En
  • Cheng, Yan
  • Morgenstern, Lewis B
  • Chalmers, John
subjects:
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Antihypertensive agents
  • Antihypertensive Agents - therapeutic use
  • Arterial hypertension. Arterial hypotension
  • Biological and medical sciences
  • Blood and lymphatic vessels
  • Blood Pressure - drug effects
  • Cardiology. Vascular system
  • Cardiovascular system
  • Cerebral Hemorrhage - diagnostic imaging
  • Cerebral Hemorrhage - drug therapy
  • Female
  • Hematoma - diagnostic imaging
  • Hematoma - drug therapy
  • Hematoma - prevention & control
  • Humans
  • Hypertension - diagnostic imaging
  • Hypertension - drug therapy
  • Male
  • Medical sciences
  • Middle Aged
  • Patient Selection
  • Pharmacology. Drug treatments
  • Radiography
  • Time Factors
  • Treatment Outcome
ispartof: Hypertension (Dallas, Tex. 1979), 2010-11, Vol.56 (5), p.852-858
description: 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 (median135 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.
language: eng
source:
identifier: ISSN: 0194-911X
fulltext: no_fulltext
issn:
  • 0194-911X
  • 1524-4563
url: Link


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titleLower Treatment Blood Pressure Is Associated With Greatest Reduction in Hematoma Growth After Acute Intracerebral Hemorrhage
creatorArima, Hisatomi ; Anderson, Craig S ; Wang, Ji Guang ; Huang, Yining ; Heeley, Emma ; Neal, Bruce ; Woodward, Mark ; Skulina, Christian ; Parsons, Mark W ; Peng, Bin ; Tao, Qing Ling ; Li, Yue Chun ; Jiang, Jian Dong ; Tai, Li Wen ; Zhang, Jin Li ; Xu, En ; Cheng, Yan ; Morgenstern, Lewis B ; Chalmers, John
creatorcontribArima, Hisatomi ; Anderson, Craig S ; Wang, Ji Guang ; Huang, Yining ; Heeley, Emma ; Neal, Bruce ; Woodward, Mark ; Skulina, Christian ; Parsons, Mark W ; Peng, Bin ; Tao, Qing Ling ; Li, Yue Chun ; Jiang, Jian Dong ; Tai, Li Wen ; Zhang, Jin Li ; Xu, En ; Cheng, Yan ; Morgenstern, Lewis B ; Chalmers, John ; Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial Investigators
descriptionThe 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 (median135 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.
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subjectAged ; Aged, 80 and over ; Analysis of Variance ; Antihypertensive agents ; Antihypertensive Agents - therapeutic use ; Arterial hypertension. Arterial hypotension ; Biological and medical sciences ; Blood and lymphatic vessels ; Blood Pressure - drug effects ; Cardiology. Vascular system ; Cardiovascular system ; Cerebral Hemorrhage - diagnostic imaging ; Cerebral Hemorrhage - drug therapy ; Female ; Hematoma - diagnostic imaging ; Hematoma - drug therapy ; Hematoma - prevention & control ; Humans ; Hypertension - diagnostic imaging ; Hypertension - drug therapy ; Male ; Medical sciences ; Middle Aged ; Patient Selection ; Pharmacology. Drug treatments ; Radiography ; Time Factors ; Treatment Outcome
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14Zhang, Jin Li
15Xu, En
16Cheng, Yan
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18Chalmers, John
19Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial Investigators
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descriptionThe 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 (median135 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.
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4Antihypertensive Agents - therapeutic use
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7Blood and lymphatic vessels
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authorArima, Hisatomi ; Anderson, Craig S ; Wang, Ji Guang ; Huang, Yining ; Heeley, Emma ; Neal, Bruce ; Woodward, Mark ; Skulina, Christian ; Parsons, Mark W ; Peng, Bin ; Tao, Qing Ling ; Li, Yue Chun ; Jiang, Jian Dong ; Tai, Li Wen ; Zhang, Jin Li ; Xu, En ; Cheng, Yan ; Morgenstern, Lewis B ; Chalmers, John
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7Blood and lymphatic vessels
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abstractThe 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 (median135 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.
copHagerstown, MD
pubAmerican Heart Association, Inc
pmid20823381
doi10.1161/HYPERTENSIONAHA.110.154328
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