Untreated hypertension as predictor of in-hospital mortality in intracerebral hemorrhage: A multi-center study

Mario Hevesi, Eric M. Bershad, Mostafa Jafari, Stephan A. Mayer, Magdy Selim, Jose I. Suarez, Afshin A. Divani

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Purpose Hypertension is a significant risk factor for intracerebral hemorrhage (ICH). The importance of managing blood pressure to reduce the risk of ICH has been recognized. However, few studies have focused on ICH outcomes due to untreated hypertension. Materials and methods We conducted a 5-year, retrospective, multicenter study of 490 consecutive ICH patients with histories of untreated-hypertension (n = 56), treated-hypertension (n = 314), and normotension (n = 120). Demographics, symptom onset, vital signs, laboratory tests, and CT imaging were documented alongside in-hospital treatments, complications, and length of stay. Results Untreated-hypertension subjects were found to be significantly younger than treated-hypertension. They were found to have lower rates of anticoagulant use (p < 0.01), antiplatelet use (p < 0.01), and hyperlipidemia (p < 0.01) than subjects with treated-hypertension. In a multivariate model, untreated-hypertension, age ≥ 65 years, ≥ 3 outpatient antihypertensive medications, and hematoma volumes ≥ 30 ml were all associated with significantly increased in-hospital mortality. In contrast, mortality was lower in patients receiving ≥ 3 antihypertensive medications while in-hospital. Conclusions Subjects with untreated-hypertension were younger and had fewer comorbidities when compared with treated-hypertension and were similar when compared to normotensive individuals. Once demographic and in-hospital factors were accounted for, untreated-hypertension subjects demonstrated significantly increased in-hospital mortality following ICH when compared with normotensive individuals.

Original languageEnglish
Pages (from-to)235-239
Number of pages5
JournalJournal of Critical Care
StatePublished - Feb 2018
Externally publishedYes


  • Chronic hypertension
  • In-hospital outcomes
  • Intracerebral hemorrhage
  • Medical management
  • Untreated hypertension


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