Study flags caution on intensive BP lowering in haemorrhagic stroke
Patients with extremely high systolic blood pressure who have an intracerebral haemorrhage fare better if antihypertensive therapy is not too aggressive, a post-hoc analysis of a major trial suggests.
The analysis found double the rate of neurological deterioration but no survival benefit with intensive versus standard blood-pressure lowering among patients whose systolic blood pressure was above 220mmHg on admission.
The original trial, ATACH-II (Antihypertensive Treatment of Acute Cerebral Haemorrhage-II), randomised patients within 4.5 hours of intracerebral haemorrhage (ICH) symptom onset to either standard or intensive blood-pressure intervention over 24 hours.
The results showed no difference in mortality or morbidity outcomes between those allocated to the intensive target of 110-139mmHg and those aiming for 140-179mmHg.
