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Magnitude of Blood Pressure Reduction and Clinical Outcomes in Acute Intracerebral Hemorrhage Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial Study
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
2015-05-01
DOI10.1161/HYPERTENSIONAHA.114.05044
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
WOS记录号WOS:000352490400097
资助机构National Health and Medical Research Council (NHMRC) of Australia ; NHMRC
引用统计
被引频次:15[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/400002259/64511
专题北京大学第一临床医学院_神经内科
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
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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.
APA Wang, Xia.,Arima, Hisatomi.,Heeley, Emma.,Delcourt, Candice.,Huang, Yining.,...&INTERACT2 Investigators.(2015).Magnitude of Blood Pressure Reduction and Clinical Outcomes in Acute Intracerebral Hemorrhage Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial Study.HYPERTENSION,65(5),1026-1032.
MLA Wang, Xia,et al."Magnitude of Blood Pressure Reduction and Clinical Outcomes in Acute Intracerebral Hemorrhage Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial Study".HYPERTENSION 65.5(2015):1026-1032.
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