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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
Wang, Xia1,2; Arima, Hisatomi1,2; Salman, Rustam Al-Shahi3; Woodward, Mark1,2,4; Heeley, Emma1,2; Stapf, Christian5,6; Lavados, Pablo M.7,8; Robinson, Thompson9,10; Huang, Yining11; Wang, Jiguang12; Delcourt, Candice1,2; Anderson, Craig S.1,2; INTERACT Investigators
关键词Intracerebral Hemorrhage Pattern Of Recovery Blood Pressure Lowering Interact Clinical Trial
刊名CEREBROVASCULAR DISEASES
2015
DOI10.1159/000381107
39期:3-4页:242-248
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Clinical Neurology ; Peripheral Vascular Disease
研究领域[WOS]Neurosciences & Neurology ; Cardiovascular System & Cardiology
关键词[WOS]RANDOMIZED CONTROLLED-TRIAL ; CEREBRAL-HEMORRHAGE ; HEMATOMA GROWTH ; ACUTE STROKE ; REDUCTION ; EDEMA ; PHASE
英文摘要

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. (C) 2015 S. Karger AG, Basel

语种英语
WOS记录号WOS:000353713300012
引用统计
被引频次:9[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/54313
专题北京大学第一临床医学院_神经内科
作者单位1.Royal Prince Alfred Hosp, Sydney, NSW, Australia
2.Univ Chile, Santiago, Chile
3.Univ Sydney, George Inst Global Hlth, Sydney, NSW 2006, Australia
4.Univ Edinburgh, Ctr Clin Brain Sci, Div Clin Neurosci, Edinburgh, Midlothian, Scotland
5.Univ Oxford, Nuffield Dept Populat Hlth, Oxford Martin Sch, George Inst Global Hlth, Oxford OX1 2JD, England
6.Univ Paris Diderot, Sorbonne Paris Cite, Hop Lariboisiere, AP HP,Dept Neurol, Paris, France
7.Univ Paris Diderot, Sorbonne Paris Cite, DHU NeuroVasc Paris Sorbonne, Paris, France
8.Univ Desarrollo, Dept Med Clin Alemana, Serv Neurol, Santiago, Chile
9.Univ Leicester, Dept Cardiovasc Sci, Leicester, Leics, England
10.Univ Leicester, NIHR Biomed Res Unit Cardiovasc Dis, Leicester, Leics, England
11.Peking Univ, Hosp 1, Dept Neurol, Beijing 100871, Peoples R China
12.Shanghai Jiao Tong Univ, Rui Jin Hosp, Shanghai Inst Hypertens, Shanghai 200030, Peoples R China
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Wang, Xia,Arima, Hisatomi,Salman, Rustam Al-Shahi,et al. Rapid Blood Pressure Lowering According to Recovery at Different Time Intervals after Acute Intracerebral Hemorrhage: Pooled Analysis of the INTERACT Studies[J]. CEREBROVASCULAR DISEASES,2015,39(3-4):242-248.
APA Wang, Xia.,Arima, Hisatomi.,Salman, Rustam Al-Shahi.,Woodward, Mark.,Heeley, Emma.,...&INTERACT Investigators.(2015).Rapid Blood Pressure Lowering According to Recovery at Different Time Intervals after Acute Intracerebral Hemorrhage: Pooled Analysis of the INTERACT Studies.CEREBROVASCULAR DISEASES,39(3-4),242-248.
MLA Wang, Xia,et al."Rapid Blood Pressure Lowering According to Recovery at Different Time Intervals after Acute Intracerebral Hemorrhage: Pooled Analysis of the INTERACT Studies".CEREBROVASCULAR DISEASES 39.3-4(2015):242-248.
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