title: Intensive blood pressure control during the hyperacute phase of intracerebral hemorrhage in patients at risk for resistant hypertension: a retrospective cohort study.
abstract: BACKGROUND
  There are limited data evaluating intensive systolic blood pressure (SBP) control during the hyperacute phase of intracerebral hemorrhage (ICH) in patients with multiple risk factors for resistant hypertension. We evaluated the feasibility and safety of this intervention in a primary population that includes patients with multiple risk factors for resistant hypertension.
  
  
  METHODS
  We conducted a retrospective analysis of ICH patients for which intensive SBP control (<140 mm Hg)- i.e. less than or equal to 140 was targeted. All patients possessed at least 2 risk factors that have been associated with resistant hypertension. Our primary objective was to determine the percentage of patients who achieved goal SBP within 1 hour of ICH diagnosis. Secondary objectives included identifying predictors of achieving goal SBP within 6 hours.
  
  
  RESULTS
  Goal SBP within 1 hour was achieved in 8.1% of patients. The total number of risk factors a patient possessed was found to negatively predict ability to achieve goal SBP. For each risk factor possessed, the odds of achieving goal SBP within 6 hours are reduced by 31% (odds ratio, 0.69 [95% confidence interval, 0.54-0.89]).
  
  
  CONCLUSIONS
  Intensive SBP control after ICH was difficult to achieve within 1 hour in those with risk factors for resistant hypertension. Patients' total risk factors were found to reduce the odds of achieving goal SBP within 6 hours.
authors.affiliation: Department of Pharmacy, Temple University Hospital, Philadelphia, PA 19140. Electronic address: kmohrien@gmail.com.
authors.forename: Kerry M
authors.initials: KM
authors.lastname: Mohrien
authors.affiliation: Department of Neurology, University of Tennessee Health Sciences Center (UTHSC), Memphis, TN 38163; Department of Neurosurgery, UTHSC, Memphis, TN 38163; Semmes-Murphey Neurologic and Spine Institute, Memphis, TN 38120. Electronic address: lelijovich@semmes-murphey.com.
authors.forename: Lucas
authors.initials: L
authors.lastname: Elijovich
authors.affiliation: College of Medicine, UTHSC, Memphis, TN 38163. Electronic address: venablegarrett@gmail.com.
authors.forename: Garrett T
authors.initials: GT
authors.lastname: Venable
authors.affiliation: Department of Neurosurgery, UTHSC, Memphis, TN 38163. Electronic address: dtaylo16@uthsc.edu.
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Taylor
authors.affiliation: Department of Neurology, University of Tennessee Health Sciences Center (UTHSC), Memphis, TN 38163; Department of Neurosurgery, UTHSC, Memphis, TN 38163; Methodist University Hospital, Memphis, TN 38104; Department of Clinical Pharmacy, UTHSC, Memphis, TN 38163. Electronic address: morgan.jones@mlh.org.
authors.forename: G Morgan
authors.initials: GM
authors.lastname: Jones
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020299:Intracranial Hemorrhage, Hypertensive / Q000188:drug therapy* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: Critical care; Hypertensive; Intracerebral hemorrhage