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学科主题: 临床医学
题名:
Optimal achieved blood pressure in acute intracerebral hemorrhage INTERACT2
作者: Arima, Hisatomi1; Heeley, Emma1; Delcourt, Candice1; Hirakawa, Yoichiro1; Wang, Xia1; Woodward, Mark1; Robinson, Thompson3,4; Stapf, Christian5; Parsons, Mark7; Lavados, Pablo M.8,9; Huang, Yining10; Wang, Jiguang11; Chalmers, John1; Anderson, Craig S.1; INTERACT2 Investigators
刊名: NEUROLOGY
发表日期: 2015-02-03
DOI: 10.1212/WNL.0000000000001205
卷: 84, 期:5, 页:464-471
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Clinical Neurology
研究领域[WOS]: Neurosciences & Neurology
关键词[WOS]: ACUTE CEREBRAL-HEMORRHAGE ; ACUTE STROKE ; HEMATOMA GROWTH ; ANTIHYPERTENSIVE TREATMENT ; REDUCTION ; MORTALITY ; ENLARGEMENT ; MANAGEMENT ; OUTCOMES ; TRIAL
英文摘要:

Objectives: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.Classification of evidence:This study provides Class I evidence that the effect of intensive BP lowering on physical function is not influenced by baseline BP.

语种: 英语
所属项目编号: 571281 ; 512402 ; 1004170
项目资助者: National Health and Medical Research Council (NHMRC) of Australia ; Australian Research Council (ARC) Future Fellowship ; NHMRC Senior Principal Research Fellowship
WOS记录号: WOS:000349442200010
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/66686
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 Chile, Dept Ciencias Neurol, Santiago, Chile
2.Royal Prince Alfred Hosp, Sydney, NSW, Australia
3.Univ Sydney, George Inst Global Hlth, Sydney, NSW 2006, Australia
4.Univ Leicester, Dept Cardiovasc Sci, Leicester LE1 7RH, Leics, England
5.Univ Leicester, NIHR Biomed Res Unit Cardiovasc Dis, Leicester LE1 7RH, Leics, England
6.Univ Paris Diderot, Sorbonne Paris Cite, Hop Lariboisiere, Dept Neurol,APHP, Paris, France
7.Univ Paris Diderot, Sorbonne Paris Cite, DHU NeuroVasc Paris, Paris, France
8.Univ Newcastle, John Hunter Hosp, Dept Neurol, Callaghan, NSW 2308, Australia
9.Univ Desarrollo, Dept Med, Clin Alemana, Serv Neurol, Santiago, Chile
10.Peking Univ, Hosp 1, Dept Neurol, Beijing 100871, Peoples R China
11.Shanghai Jiao Tong Univ, Rui Jin Hosp, Shanghai Inst Hypertens, Shanghai 200030, Peoples R China

Recommended Citation:
Arima, Hisatomi,Heeley, Emma,Delcourt, Candice,et al. Optimal achieved blood pressure in acute intracerebral hemorrhage INTERACT2[J]. NEUROLOGY,2015,84(5):464-471.
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