Optimal achieved blood pressure in acute intracerebral hemorrhage INTERACT2

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dc.contributor.authorArima, Hisatomi
dc.contributor.authorHeeley, Emma
dc.contributor.authorDelcourt, Candice
dc.contributor.authorHirakawa, Yoichiro
dc.contributor.authorWang, Xia
dc.contributor.authorWoodward, Mark
dc.contributor.authorThompson, Robinson
dc.contributor.authorStapf, Christian
dc.contributor.authorParsons, Mark
dc.contributor.authorLavados, Pablo
dc.contributor.authorHuang, Yining
dc.contributor.authorWang, Jiguang
dc.contributor.authorChalmers, John
dc.contributor.authorAnderson, Craig
dc.contributor.authorINTERACT2 Investigators
dc.date.accessioned2016-08-02T19:30:38Z
dc.date.available2016-08-02T19:30:38Z
dc.date.issued2015
dc.description.abstractOBJECTIVES: To investigate the effects of intensive blood pressure (BP) lowering according to baseline BP levels and optimal achieved BP levels in patients with acute intracerebral hemorrhage (ICH). METHODS: INTERACT2 was an open, blinded endpoint, randomized controlled trial in 2,839 patients with ICH within 6 hours of onset and elevated systolic BP (SBP) (150-220 mm Hg) who were allocated to receive intensive (target SBP <140 mm Hg within 1 hour, with lower limit of 130 mm Hg for treatment cessation) or guideline-recommended (target SBP <180 mm Hg) BP-lowering treatment. Outcome was physical function across all 7 levels of the modified Rankin Scale at 90 days. RESULTS: Analysis of the randomized comparisons showed that intensive BP lowering produced comparable benefits on physical function at 90 days in 5 subgroups defined by baseline SBP of <160, 160-169, 170-179, 180-189, and ≥190 mm Hg (p homogeneity = 0.790). Analyses of achieved BP showed linear increases in the risk of physical dysfunction for achieved SBP above 130 mm Hg for both hyperacute (1-24 hours) and acute (2-7 days) phases while modest increases were also observed for achieved SBP below 130 mm Hg. CONCLUSIONS: Intensive BP lowering appears beneficial across a wide range of baseline SBP levels, and target SBP level of 130-139 mm Hg is likely to provide maximum benefit in acute ICH.
dc.identifier.citationNeurology, Feb 2015, vol.84, n°5, p.464–471
dc.identifier.urihttp://hdl.handle.net/11447/719
dc.identifier.urihttp://dx.doi.org/10.1212/WNL.0000000000001205
dc.language.isoen_US
dc.publisherAmerican Academy of Neurology
dc.subjectBlood pressure
dc.subjectCerebral hemorrhage
dc.subjectAntihypertensive agents
dc.titleOptimal achieved blood pressure in acute intracerebral hemorrhage INTERACT2
dc.typeArtículo

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