title: Admission Heart Rate Predicts Poor Outcomes in Acute Intracerebral Hemorrhage: The Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial Studies.
abstract: Faster heart rate predicts higher mortality in coronary heart disease and acute ischemic stroke, but its prognostic significance in intracerebral hemorrhage remains uncertain. We aimed to determine the effect of admission heart rate on clinical and imaging outcomes in patients with intracerebral hemorrhage.
  
  
  
  A post hoc pooled analysis of the pilot and main phases of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT 1 and 2). Clinical outcomes were mortality and modified Rankin Scale score at 90 days; and imaging outcome was absolute growth in hematoma volume during the initial 24 hours. Patients were divided into 4 categories according to baseline heart rate (<65, 65-74, 75-84, and ≥85 bpm) and analyzed using multivariable adjusted models with the lowest heart rate group as the reference.
  
  
  
  Of 3185 patients with available data, higher admission heart rate was associated with both mortality and worse modified Rankin Scale score: adjusted hazard ratio for heart rate (≥85 versus <65 bpm) 1.50 (95% confidence interval, 1.07-2.11) and adjusted odds ratio 1.33 (95% confidence interval, 1.08-1.63), respectively (both P-trend <0.05). There was no significant relationship between heart rate and absolute growth in hematoma volume (P-trend, 0.196).
  
  
  
  Higher admission heart rate is independently associated with death and poor functional outcome after acute intracerebral hemorrhage.
  
  
  
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT00226096 and NCT00716079.
authors.affiliation: From the Neurological and Mental Health Division, The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia (M.Q., S.S., D.Z., X.W., C.C., Y.H., E.C.S., C.D., J.C., C.S.A.); The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China (M.Q., J.W.); Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan (S.S.); Neurology Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia (C.C., C.D., J.C., C.S.A.); Department of Neurology, Oslo University Hospital, Oslo, Norway (E.C.S.); and Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan (H.A.).
authors.forename: Miaoyan
authors.initials: M
authors.lastname: Qiu
authors.affiliation: From the Neurological and Mental Health Division, The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia (M.Q., S.S., D.Z., X.W., C.C., Y.H., E.C.S., C.D., J.C., C.S.A.); The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China (M.Q., J.W.); Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan (S.S.); Neurology Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia (C.C., C.D., J.C., C.S.A.); Department of Neurology, Oslo University Hospital, Oslo, Norway (E.C.S.); and Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan (H.A.).
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Sato
authors.affiliation: From the Neurological and Mental Health Division, The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia (M.Q., S.S., D.Z., X.W., C.C., Y.H., E.C.S., C.D., J.C., C.S.A.); The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China (M.Q., J.W.); Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan (S.S.); Neurology Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia (C.C., C.D., J.C., C.S.A.); Department of Neurology, Oslo University Hospital, Oslo, Norway (E.C.S.); and Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan (H.A.).
authors.forename: Danni
authors.initials: D
authors.lastname: Zheng
authors.affiliation: From the Neurological and Mental Health Division, The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia (M.Q., S.S., D.Z., X.W., C.C., Y.H., E.C.S., C.D., J.C., C.S.A.); The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China (M.Q., J.W.); Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan (S.S.); Neurology Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia (C.C., C.D., J.C., C.S.A.); Department of Neurology, Oslo University Hospital, Oslo, Norway (E.C.S.); and Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan (H.A.).
authors.forename: Xia
authors.initials: X
authors.lastname: Wang
authors.affiliation: From the Neurological and Mental Health Division, The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia (M.Q., S.S., D.Z., X.W., C.C., Y.H., E.C.S., C.D., J.C., C.S.A.); The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China (M.Q., J.W.); Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan (S.S.); Neurology Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia (C.C., C.D., J.C., C.S.A.); Department of Neurology, Oslo University Hospital, Oslo, Norway (E.C.S.); and Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan (H.A.).
authors.forename: Cheryl
authors.initials: C
authors.lastname: Carcel
authors.affiliation: From the Neurological and Mental Health Division, The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia (M.Q., S.S., D.Z., X.W., C.C., Y.H., E.C.S., C.D., J.C., C.S.A.); The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China (M.Q., J.W.); Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan (S.S.); Neurology Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia (C.C., C.D., J.C., C.S.A.); Department of Neurology, Oslo University Hospital, Oslo, Norway (E.C.S.); and Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan (H.A.).
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Hirakawa
authors.affiliation: From the Neurological and Mental Health Division, The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia (M.Q., S.S., D.Z., X.W., C.C., Y.H., E.C.S., C.D., J.C., C.S.A.); The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China (M.Q., J.W.); Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan (S.S.); Neurology Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia (C.C., C.D., J.C., C.S.A.); Department of Neurology, Oslo University Hospital, Oslo, Norway (E.C.S.); and Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan (H.A.).
authors.forename: Else C
authors.initials: EC
authors.lastname: Sandset
authors.affiliation: From the Neurological and Mental Health Division, The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia (M.Q., S.S., D.Z., X.W., C.C., Y.H., E.C.S., C.D., J.C., C.S.A.); The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China (M.Q., J.W.); Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan (S.S.); Neurology Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia (C.C., C.D., J.C., C.S.A.); Department of Neurology, Oslo University Hospital, Oslo, Norway (E.C.S.); and Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan (H.A.).
authors.forename: Candice
authors.initials: C
authors.lastname: Delcourt
authors.affiliation: From the Neurological and Mental Health Division, The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia (M.Q., S.S., D.Z., X.W., C.C., Y.H., E.C.S., C.D., J.C., C.S.A.); The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China (M.Q., J.W.); Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan (S.S.); Neurology Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia (C.C., C.D., J.C., C.S.A.); Department of Neurology, Oslo University Hospital, Oslo, Norway (E.C.S.); and Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan (H.A.).
authors.forename: Hisatomi
authors.initials: H
authors.lastname: Arima
authors.affiliation: From the Neurological and Mental Health Division, The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia (M.Q., S.S., D.Z., X.W., C.C., Y.H., E.C.S., C.D., J.C., C.S.A.); The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China (M.Q., J.W.); Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan (S.S.); Neurology Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia (C.C., C.D., J.C., C.S.A.); Department of Neurology, Oslo University Hospital, Oslo, Norway (E.C.S.); and Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan (H.A.).
authors.forename: Jiguang
authors.initials: J
authors.lastname: Wang
authors.affiliation: From the Neurological and Mental Health Division, The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia (M.Q., S.S., D.Z., X.W., C.C., Y.H., E.C.S., C.D., J.C., C.S.A.); The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China (M.Q., J.W.); Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan (S.S.); Neurology Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia (C.C., C.D., J.C., C.S.A.); Department of Neurology, Oslo University Hospital, Oslo, Norway (E.C.S.); and Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan (H.A.).
authors.forename: John
authors.initials: J
authors.lastname: Chalmers
authors.affiliation: From the Neurological and Mental Health Division, The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia (M.Q., S.S., D.Z., X.W., C.C., Y.H., E.C.S., C.D., J.C., C.S.A.); The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China (M.Q., J.W.); Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan (S.S.); Neurology Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia (C.C., C.D., J.C., C.S.A.); Department of Neurology, Oslo University Hospital, Oslo, Norway (E.C.S.); and Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan (H.A.). canderson@georgeinstitute.org.au.
authors.forename: Craig S
authors.initials: CS
authors.lastname: Anderson
mesh_terms: D000367:Age Factors; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D002543:Cerebral Hemorrhage / Q000401:mortality / Q000628:therapy*; D018450:Disease Progression; D004311:Double-Blind Method; D005260:Female; D015600:Glasgow Coma Scale; D006339:Heart Rate; D006406:Hematoma / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D020127:Recovery of Function; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: cerebral hemorrhage; heart rate; hematoma; outcomes research; stroke