title: Clinical analysis of factors predisposing the recurrence of primary intracerebral hemorrhage in patients taking anti-hypertensive drugs: a prospective cohort study.
abstract: OBJECTIVE
  The study examined differences in the recurrence rate of primary intracerebral hemorrhage (P-ICH) according to anti-hypertensive drug (AHD) use by patients with hypertension.
  
  
  METHODS
  This prospective, longitudinal cohort study was performed on 2384 patients diagnosed with supratentorial P-ICH and hypertension in the stroke unit of a single-center. During follow-up (mean, 44.9±31.5 months), investigators interviewed subjects or caregivers by telephone or examined patients every 3-6 months. Target blood pressure was <140/90 mmHg in the P-ICH cohort with hypertension.
  
  
  RESULTS
  Of 1317 P-ICH patients defined to be taking AHDs, P-ICH recurrence occurred in 129 (9.8%). 1211 patients (92.0%) reached target blood pressure. In multivariate regression analysis, advanced age (≥70 years), poor functional outcome after first P-ICH, lobar location of P-ICH, previous history of cerebral ischemia, diuretic monotherapy and α- or β-blocker monotherapy were associated with risk of recurrence.
  
  
  CONCLUSIONS
  Although hypertension is the most important factor for preventing P-ICH recurrence, we found that, even in the presence of optimal anti-hypertensive medication, recurrent P-ICH attack can occur. Therefore, management of other risk factors of recurrent P-ICH, such as modification of lifestyle, must be considered in treating the P-ICH patients.
authors.affiliation: Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea.
authors.forename: Young Zoon
authors.initials: YZ
authors.lastname: Kim
authors.forename: Yong Hwan
authors.initials: YH
authors.lastname: Park
authors.forename: Yun Gyu
authors.initials: YG
authors.lastname: Song
authors.forename: Kyu Hong
authors.initials: KH
authors.lastname: Kim
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D023261:Glasgow Outcome Scale; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D020300:Intracranial Hemorrhages / Q000453:epidemiology* / Q000601:surgery; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000503:physiopathology; D014057:Tomography, X-Ray Computed
chemical_list: D000959:Antihypertensive Agents