title: Effects of Intensive Blood Pressure Lowering on Intracerebral Hemorrhage Outcomes: A Meta-Analysis of Randomized Controlled Trials.
abstract: OBJECTIVE
  Elevation of blood pressure (BP) is common after intracerebral hemorrhage (ICH). Early BP treatment may be beneficial after ICH, but the effect of intensive BP lowering on ICH outcomes is not known and no systematic review or meta-analysis was published regarding this issue.
  
  
  METHODS
  We conducted a meta-analysis to compare the effect of more versus less intensive BP targets on clinical outcomes in patients with ICH. Mortality, unfavorable outcome and adverse events were analyzed. Meta-analysis was performed in terms of the odds ratio (OR) and 95% confidence interval (CI).
  
  
  RESULTS
  Five eligible studies were included and analyzed, involving 3243 patients to use systolic BP (SBP) < 140 mmHg as target BP and 142 patients to use other BP target in intensive BP target group. The pooled OR of mortality and unfavorable outcome after ICH in intensive BP control group comparing with less intensive BP targets group were 0.99 (95% CI 0.81 to 1.23) and 0.90 (95% CI 0.78 to 1.03) respectively. The pooled OR were 0.97 (95% CI 0.80 to 1.18) for neurological deterioration and 0.83 (95% CI 0.61 to 1.11) for hematoma expansion. There is no difference in other adverse events between two groups.
  
  
  CONCLUSIONS
  Acute lowering of SBP to 140 mmHg is probably beneficial for functional outcome in patients with ICH, but the evidence is still insufficient. Further large multicenter studies are required to enhance the evidence to guide the BP lowering target following ICH.
authors.affiliation: Sichuan University, West China Hospital, Department of Neurosurgery, Chengdu, China.
authors.forename: Junpeng
authors.initials: J
authors.lastname: Ma
authors.forename: Hao
authors.initials: H
authors.lastname: Li
authors.forename: Yi
authors.initials: Y
authors.lastname: Liu
authors.forename: Chao
authors.initials: C
authors.lastname: You
authors.forename: Siqing
authors.initials: S
authors.lastname: Huang
authors.forename: Lu
authors.initials: L
authors.lastname: Ma
mesh_terms: D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001794:Blood Pressure; D002543:Cerebral Hemorrhage / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D004334:Drug Administration Schedule; D006801:Humans; D020299:Intracranial Hemorrhage, Hypertensive / Q000188:drug therapy; D009422:Nervous System Diseases / Q000209:etiology; D016017:Odds Ratio; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents