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学科主题: 临床医学
题名:
Magnitude of Blood Pressure Reduction and Clinical Outcomes in Acute Intracerebral Hemorrhage Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial Study
作者: Wang, Xia1; Arima, Hisatomi1; Heeley, Emma1; Delcourt, Candice1; Huang, Yining2; Wang, Jiguang3; Stapf, Christian4,5; Robinson, Thompson6,7; Woodward, Mark1; Chalmers, John1; Anderson, Craig S.1; INTERACT2 Investigators
关键词: cerebral hemorrhage ; clinical trial ; hypertension ; treatment outcome
刊名: HYPERTENSION
发表日期: 2015-05-01
DOI: 10.1161/HYPERTENSIONAHA.114.05044
卷: 65, 期:5, 页:1026-1032
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Peripheral Vascular Disease
研究领域[WOS]: Cardiovascular System & Cardiology
关键词[WOS]: STROKE ACUTE MANAGEMENT ; RISK-FACTOR ASSESSMENT ; NEUROLOGICAL DETERIORATION ; ANTIHYPERTENSIVE-TREATMENT ; PERIHEMATOMAL EDEMA ; INTERACT2 ; HEMATOMA ; HYPERTENSION ; IMPACT
英文摘要:

Evidence supports early intensive blood pressure (BP) lowering in acute intracerebral hemorrhage, but uncertainty persists over whether potential benefits and harms vary according to the magnitude of BP reduction. We aimed to determine whether larger systolic BP (SBP) reductions were associated with better outcomes in participants of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2). INTERACT2 was an international, open, blinded end point, randomized controlled trial of patients with spontaneous intracerebral hemorrhage (<6 hours) and elevated SBP (150-220 mm Hg) assigned to intensive (target SBP <140 mm Hg) or guideline-recommended (SBP <180 mm Hg) treatment. Associations of BP reduction (baseline minus average of achieved SBP) during 3 time periods post randomization (15-60 minutes, 1-24 hours, and 2-7 days) on poor outcome (death or major disability) at 90 days were analyzed in multivariable logistic regression models with odds ratios and 95% confidence intervals. Larger SBP reductions within the first hour after randomization were associated with lower risks of poor outcome: compared with minimal reduction (<10 mm Hg), odds ratios were 0.80 (95% confidence interval, 0.63-1.02) for moderate (10-20 mm Hg) and 0.65 (0.52-0.82) for large (>= 20 mm Hg) reductions (P trend <0.01). Similar associations were also observed for SBP reductions during 1 to 24 hours (P<0.01) and 2 to 7 days (P 0.02). No heterogeneity in associations for patients above or below baseline SBP 180 mm Hg was reported (P>0.30). Optimal recovery from intracerebral hemorrhage was observed in hypertensive patients who achieved the greatest SBP reductions (>= 20 mm Hg) in the first hour and maintained for 7 days.

语种: 英语
项目资助者: National Health and Medical Research Council (NHMRC) of Australia ; NHMRC
WOS记录号: WOS:000352490400097
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/64511
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.Univ Sydney, Royal Prince Alfred Hosp, George Inst Global Hlth, Neurol & Mental Hlth Div, Sydney, NSW 2050, Australia
2.Peking Univ, Hosp 1, Dept Neurol, Beijing 100871, Peoples R China
3.Shanghai Jiao Tong Univ, Ctr Epidemiol Studies & Clin Trials, Shanghai Inst Hypertens, Ruijin Hosp,Sch Med, Shanghai 200030, Peoples R China
4.Univ Paris Diderot, Sorbonne Paris Cite, Hop Lariboisiere, APHP,Dept Neurol, Paris, France
5.Univ Paris Diderot, Sorbonne Paris Cite, DHU NeuroVasc Paris Sorbonne, Paris, France
6.Univ Leicester, Dept Cardiovasc Sci, Leicester, Leics, England
7.Univ Leicester, NIHR Biomed Res Unit Cardiovasc Dis, Leicester, Leics, England

Recommended Citation:
Wang, Xia,Arima, Hisatomi,Heeley, Emma,et al. Magnitude of Blood Pressure Reduction and Clinical Outcomes in Acute Intracerebral Hemorrhage Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial Study[J]. HYPERTENSION,2015,65(5):1026-1032.
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