Relation between blood pressure and outcome in intracerebral hemorrhage.
OBJECTIVE
Controversy continues to exist regarding optimal blood pressure control in acute hypertensive intracerebral hemorrhage. Persistent marked elevation of the blood pressure can promote further bleeding, increase cerebral blood flow, and raise intracranial pressure. Relative hypotension, on the other hand, may promote hypoperfusion with secondary ischemia. This study was designed to assess outcome in patient groups defined by the degree of elevation in their pretreatment and posttreatment blood pressures.


METHODS
We retrospectively assessed 87 patients who were categorized according to an initial mean arterial pressure > 145 mm Hg (n = 34) compared with those with a pressure < or = 145 mm Hg (n = 53). We also studied blood pressure control within the first 2 to 6 hours of presentation with subjects categorized according to a mean arterial pressure > 125 mm Hg (n = 40) or < or = 125 mm Hg (n = 47).


RESULTS
An improved outcome in both mortality and severe morbidity was observed in the < or = 145 (chi 2 = 7.0, P < .005) and the < or = 125 mm Hg (chi 2 = 6.7, P < .005) groups.


CONCLUSIONS
Markedly elevated blood pressure on admission and persistent inadequate blood pressure control adversely affect the prognosis in hypertensive intracerebral hemorrhage.
Department of Neurology, University of Miami School of Medicine, FL.
B K
BK
Dandapani
S
S
Suzuki
R E
RE
Kelley
Y
Y
Reyes-Iglesias
R C
RC
Duncan
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D002543:Cerebral Hemorrhage / Q000150:complications / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy; D015897:Comorbidity; D004677:Encephalocele / Q000209:etiology / Q000401:mortality; D005260:Female; D005431:Florida / Q000453:epidemiology; D006331:Heart Diseases / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D007022:Hypotension / Q000150:complications / Q000517:prevention & control; D007427:Intracranial Pressure; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
D000959:Antihypertensive Agents