TY - JOUR
T1 - Continuous antihypertensive therapy throughout the initial 24 hours of intracerebral hemorrhage
T2 - The stroke acute management with urgent risk-factor assessment and improvement-intracerebral hemorrhage study
AU - Kobayashi, Junpei
AU - Koga, Masatoshi
AU - Tanaka, Eijirou
AU - Okada, Yasushi
AU - Kimura, Kazumi
AU - Yamagami, Hiroshi
AU - Okuda, Satoshi
AU - Hasegawa, Yasuhiro
AU - Shiokawa, Yoshiaki
AU - Furui, Eisuke
AU - Nakagawara, Jyoji
AU - Kario, Kazuomi
AU - Okata, Takuya
AU - Arihiro, Shoji
AU - Sato, Shoichiro
AU - Nagatsuka, Kazuyuki
AU - Minematsu, Kazuo
AU - Toyoda, Kazunori
PY - 2014/3
Y1 - 2014/3
N2 - Background and Purpose- A short duration (<24 hours) of antihypertensive therapy (AHT) after acute intracerebral hemorrhage (ICH) may be sufficient because active bleeding generally ceases within several hours. We aimed to determine the association between sequential systolic blood pressure (SBP) levels during AHT and outcomes in ICH patients. Methods-In 211 hyperacute ICH patients who underwent AHT based on predefined protocol, the mean of hourly SBP (mSBP) measurements was calculated over 1 to 8 hours (first mSBP), 9 to 16 hours (second mSBP), and 17 to 24 hours (third mSBP) after the initiation of AHT. Outcomes included neurological deterioration (72-hour Glasgow Coma Scale decrease ≥2 or National Instititutes of Health Stroke Scale increase ≥4), hematoma expansion (>33%), and unfavorable outcome (3-month modified Rankin Scale score 4-6). Results- The median first, second, and third mSBPs were 132, 131, and 137 mmHg, respectively. A higher first mSBP (odds ratio [OR], 2.41; 95% confidence interval ICIJ, 1.34- A69 per 10 mmHg) or second mSBP (OR. 2.08; 95% CI. 1.20-3.80) was independently associated with neurological deterioration, and a higher second mSBP (OR, 1.40; 95% CI, 1.02-2.00) or third mSBP (OR, 1.45; 95% CI. 1.05-2.05) was associated with unfavorable outcome. None of the mSBPs was associated with hematoma expansion. Conclusions- The continuation of AHT throughout the initial 24 hours after ICH may improve outcomes.
AB - Background and Purpose- A short duration (<24 hours) of antihypertensive therapy (AHT) after acute intracerebral hemorrhage (ICH) may be sufficient because active bleeding generally ceases within several hours. We aimed to determine the association between sequential systolic blood pressure (SBP) levels during AHT and outcomes in ICH patients. Methods-In 211 hyperacute ICH patients who underwent AHT based on predefined protocol, the mean of hourly SBP (mSBP) measurements was calculated over 1 to 8 hours (first mSBP), 9 to 16 hours (second mSBP), and 17 to 24 hours (third mSBP) after the initiation of AHT. Outcomes included neurological deterioration (72-hour Glasgow Coma Scale decrease ≥2 or National Instititutes of Health Stroke Scale increase ≥4), hematoma expansion (>33%), and unfavorable outcome (3-month modified Rankin Scale score 4-6). Results- The median first, second, and third mSBPs were 132, 131, and 137 mmHg, respectively. A higher first mSBP (odds ratio [OR], 2.41; 95% confidence interval ICIJ, 1.34- A69 per 10 mmHg) or second mSBP (OR. 2.08; 95% CI. 1.20-3.80) was independently associated with neurological deterioration, and a higher second mSBP (OR, 1.40; 95% CI, 1.02-2.00) or third mSBP (OR, 1.45; 95% CI. 1.05-2.05) was associated with unfavorable outcome. None of the mSBPs was associated with hematoma expansion. Conclusions- The continuation of AHT throughout the initial 24 hours after ICH may improve outcomes.
KW - Acute
KW - Antihypertensives
KW - Cerebral hemorrhage
KW - Patient outcome assessment
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=84899490485&partnerID=8YFLogxK
U2 - 10.1161/STROKEAHA.113.004319
DO - 10.1161/STROKEAHA.113.004319
M3 - Article
C2 - 24425118
AN - SCOPUS:84899490485
SN - 0039-2499
VL - 45
SP - 868
EP - 870
JO - Stroke
JF - Stroke
IS - 3
ER -