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Prof. Craig Anderson
Early intensive lowering of blood pressure may have some benefit in patients with in acute intracerebral haemorrhage (ICH), an Australian-led systematic review has found
Professor Craig Anderson, Professor of Neurology and Epidemiology at the University of NSW presented findings at the European Stroke Organisation (ESO)-World Stroke Organisation (WSO) 2020 Virtual Conference showing a 25% reduction in haematoma volume growth in the first 24 hours in patients who had early lowering of BP after ICH.
But uncertainty persists over the timing and strategy of BP lowering, he told the virtual meeting.
Professor Anderson told the meeting that until now, scientific studies have not yet sufficiently explained what are the benefits from intensive BP lowering in patients with haemorrhagic stroke.
Therefore, a systematic review with meta-analysis was conducted of the Cochrane Central Register of Controlled Trials, EMBASE and MEDLINE databases to identify randomised controlled trials of BP management in adults with acute ICH.
The authors were able to use individual patient data from 16 randomised controlled trials on BP management within seven days of the onset of the acute disease process in adult patients with haemorrhagic insult.
Overall, these studies included 6,221 patients eligible for analysis (mean age of 64 years, 36% females, median time at enrolment 3.8 hours after onset of symptoms).
Intensive antihypertensive therapy lowered the BP median to 158.6 mmHg systolic within an hour after treatment began (placebo: 166 mmHg) and a median of 144.3 mmHg within 24 hours (placebo: median of 156.4 mmHg).