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学科主题: 临床医学
题名:
Rapid Blood Pressure Lowering According to Recovery at Different Time Intervals after Acute Intracerebral Hemorrhage: Pooled Analysis of the INTERACT Studies
作者: 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
发表日期: 2015
DOI: 10.1159/000381107
卷: 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
所属项目编号: 358395 ; 571281 ; 512402 ; 1004170
项目资助者: NHMRC of Australia ; NHMRC
WOS记录号: WOS:000353713300012
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/54313
Appears in Collections:北京大学第一临床医学院_神经内科_期刊论文

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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

Recommended Citation:
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.
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