title: Potential blood pressure thresholds and outcome in acute intracerebral hemorrhage.
abstract: BACKGROUND
  Little is known about the relationships between different systolic blood pressure (SBP) thresholds and their outcomes in acute intracerebral hemorrhage (ICH). We aimed to determine the associations of potential systolic blood pressure (SBP) thresholds with hematoma growth (HG) and clinical outcome in patients with acute ICH.
  
  
  METHODS
  117 patients with acute (<6 h) spontaneous supratentorial ICH underwent blood pressure monitoring at 15 min interval over the first 24 h. SBP thresholds of 140, 150, 160, 170, 180, 190, and 200 mm Hg were assessed by means of the percentage of 24-hour values exceeding each threshold (SBP load). HG at 24 h, early neurological deterioration (END), 24-hour and 90-day mortality, and poor outcome were recorded.
  
  
  RESULTS
  SBP 170, 180, 190, and 200 loads were significantly correlated with the amount of both absolute and relative hematoma enlargement at 24 h. In multivariate analyses, SBP 170 load was related to HG and END, while SBP 160 load was associated with mortality at 24 h. No thresholds were independently related to outcomes at 90 days.
  
  
  CONCLUSIONS
  In patients with acute ICH, SBP lowering to at least less than 160 mm Hg threshold may be needed to minimize the deleterious effect of high SBP on 24-hour outcomes.
authors.affiliation: Stroke Unit, Department of Neurology, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Rodriguez-Luna
authors.forename: Marian
authors.initials: M
authors.lastname: Muchada
authors.forename: Socorro
authors.initials: S
authors.lastname: Piñeiro
authors.forename: Alan
authors.initials: A
authors.lastname: Flores
authors.forename: Marta
authors.initials: M
authors.lastname: Rubiera
authors.forename: Jorge
authors.initials: J
authors.lastname: Pagola
authors.forename: Pilar
authors.initials: P
authors.lastname: Coscojuela
authors.forename: Pilar
authors.initials: P
authors.lastname: Meler
authors.forename: Estela
authors.initials: E
authors.lastname: Sanjuan
authors.forename: Sandra
authors.initials: S
authors.lastname: Boned-Riera
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Cárcamo
authors.forename: Alejandro
authors.initials: A
authors.lastname: Tomasello
authors.forename: Jose
authors.initials: J
authors.lastname: Alvarez-Sabin
authors.forename: Marc
authors.initials: M
authors.lastname: Ribo
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Molina
mesh_terms: D000208:Acute Disease; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000401:mortality; D005260:Female; D015600:Glasgow Coma Scale; D006406:Hematoma / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012372:ROC Curve; D012189:Retrospective Studies; D015898:Tomography Scanners, X-Ray Computed