Management of acute hypertensive response in patients with intracerebral hemorrhage.
Spontaneous intracerebral hemorrhage (ICH) is intra-parenchymal bleeding that may lead to localized hematoma formation. The hematoma can enlarge over a period of time, and directly contribute to neurological deterioration and death. Several studies have shown a relationship between acute hypertensive response and poor prognosis among patients with ICH; however, it is somewhat unclear whether hematomal expansion, is a cause or a result of elevated blood pressure (BP). Current AHA guidelines state MAP should be maintained <130 mmHg and systolic blood pressure (SBP) <180 mmHg. Two major clinical trials demonstrating tolerability and safety of aggressive BP management to BP <140 mmHg in the acute phase of ICH were the ATACH (2004-2008) and INTERACT (2005-2007) trials. ATACH II and INTERACT 2 trials are currently being conducted to demonstrate the efficacy of SBP reduction as the next step to the ATACH and INTERACT pilot trials.
Zeenat Qureshi Stroke Research Center, University of Minnesota, Minneapolis, USA.
Syeda L
SL
Alqadri
Adnan I
AI
Qureshi
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001921:Brain / Q000098:blood supply / Q000378:metabolism*; D002543:Cerebral Hemorrhage / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*
D000959:Antihypertensive Agents