Intensive Blood Pressure Lowering Potentially Harmful in ICH

Intensive lowering of systolic blood pressure (SBP) for patients with intracerebral hemorrhage (ICH) whose initial SBP is excessively high does not improve outcomes and is linked to safety concerns, new research shows.

Investigators found that ICH patients whose initial SBP was 220 mmHg and who underwent intensive BP lowering had twice the relative risk for neurologic deterioration at 24 hours without any reduction in hematoma expansion or 3-month risk for death and disability compared to their counterparts who underwent standard SBP lowering.

“The significantly higher rate of neurological deterioration associated with intensive treatment in patients with initial systolic blood pressure of 220 mm Hg or more warrants caution against broad recommendations for intensive systolic blood pressure reduction in patients with intracerebral hemorrhage,” the investigators, led by Iryna Lobanova, MD, Zeenat Qureshi Stroke Institute, University of Missouri, in Columbia, write.

The study was published online September 8 in JAMA Neurology.

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