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Rapid Blood Pressure Lowering According to Recovery at Different Time Intervals after Acute Intracerebral Hemorrhage: Pooled Analysis of the INTERACT Studies.

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dc.contributor.author Wang, Xia
dc.contributor.author Arima, Hisatomi
dc.contributor.author Al-Shahi Salman, Rustam
dc.contributor.author Woodward, Mark
dc.contributor.author Heeley, Emma
dc.contributor.author Stapf, Christian
dc.contributor.author Lavados, Pablo
dc.contributor.author Thompson, Robinson
dc.contributor.author Huang, Yining
dc.contributor.author Wang, Jiguang
dc.contributor.author Delcourt, Candice
dc.contributor.author Anderson, Craig
dc.contributor.author INTERACT Investigators
dc.date.accessioned 2016-05-16T18:03:07Z
dc.date.available 2016-05-16T18:03:07Z
dc.date.issued 2015
dc.identifier.citation Cerebrovascular Diseases, 2015, vol.39, n°3-4, p.242-248
dc.identifier.uri http://hdl.handle.net/11447/255
dc.identifier.uri http://dx.doi.org/10.1159/000381107
dc.description.abstract BACKGROUND AND PURPOSE: Early intensive blood pressure (BP) lowering has been shown to improve functional outcome in acute intracerebral hemorrhage (ICH), but the treatment effect is modest and without a clearly defined underlying explanatory mechanism. We aimed at more reliably quantifying the benefits of this treatment according to different time periods in the recovery of participants in the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT) studies. METHODS: Pooled analysis of the pilot INTERACT1 (n = 404) and main INTERACT2 (n = 2,839) involving patients with spontaneous ICH (<6 h) and elevated systolic BP (SBP 150-220 mm Hg) who were randomized to intensive (target SBP <140 mm Hg) or guideline-recommended (target SBP <180 mm Hg) BP lowering treatment. Treatment effects were examined according to repeated measures analysis of an ordinal ('shift') across all 7 levels of the modified Rankin Scale (mRS) assessed during follow-up at 7, 28, and 90 days, post-randomization. CLINICAL TRIAL REGISTRATION INFORMATION: http://www.clinicaltrials.gov, NCT00226096 and NCT00716079. RESULTS: Intensive BP lowering resulted in a significant favorable distribution of mRS scores for better functioning (odds ratio 1.13, 95% confidence interval 1.00-1.26; p = 0.042) over 7, 28 and 90 days, and the effect was consistency for early (7-28 days) and later (28-90 days) time periods (p homogeneity 0.353). Treatment effects were also consistent across several pre-specified patient characteristic subgroups, with trends favoring those randomized early, and with higher SBP and milder neurological severity at baseline. CONCLUSIONS: Intensive BP lowering provides beneficial effects on physical functioning that manifests consistently through the early and later phases of recovery from ICH.
dc.language.iso en_US
dc.publisher S. Karger AG, Basel
dc.subject Acute disease
dc.subject Blood pressure
dc.subject Cerebral hemorrhage,complications
dc.title Rapid Blood Pressure Lowering According to Recovery at Different Time Intervals after Acute Intracerebral Hemorrhage: Pooled Analysis of the INTERACT Studies.
dc.type Artículo


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