title: Management of Acute Hypertensive Response in Intracerebral Hemorrhage Patients After ATACH-2 Trial.
abstract: Acute hypertensive response is elevation of systolic blood pressure (SBP) in the first 24 h after symptom onset which is highly prevalent in patients with intracerebral hemorrhage (ICH). Observational studies suggested association between acute hypertensive response and hematoma expansion, peri-hematoma edema and death and disability, and possible reduction in these adverse outcomes with treatment of acute hypertensive response. Recent clinical trials have focused on determining the clinical efficacy of early intensive SBP reduction in ICH patients. The Antihypertensive Treatment of Acute Cerebral Hemorrhage (ATACH-2) trial was the latest phase 3 randomized controlled multicenter clinical trial aimed to study the efficacy of early intensive reduction of SBP in ICH patients. In this review article, we summarize the results of recent clinical trials, treatment principles based on the latest guidelines, and the anticipated interpretation and incorporation of ATACH-2 trial results in clinical practice.
authors.affiliation: Department of Neurology, George Washington University, Washington, DC, USA. majidis@gwu.edu.|Zeenat Qureshi Stroke Institute, St. Cloud, MN, USA. majidis@gwu.edu.
authors.forename: Shahram
authors.identifier: http://orcid.org/0000-0001-7091-595X
authors.initials: S
authors.lastname: Majidi
authors.affiliation: Division of Vascular Neurology and Neurocritical Care, Baylor College of Medicine and CHI Baylor St Luke's Medical Center, Houston, TX, USA.
authors.forename: Jose I
authors.initials: JI
authors.lastname: Suarez
authors.affiliation: Zeenat Qureshi Stroke Institute, St. Cloud, MN, USA.
authors.forename: Adnan I
authors.initials: AI
authors.lastname: Qureshi
mesh_terms: D002543:Cerebral Hemorrhage / Q000150:complications / Q000628:therapy*; D017326:Clinical Trials, Phase III as Topic; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000628:therapy*; D015337:Multicenter Studies as Topic; D010043:Outcome and Process Assessment, Health Care; D016032:Randomized Controlled Trials as Topic
keywords: Acute hypertensive response; Clinical trial; Death; Disability; Hematoma expansion; Intracerebral hemorrhage; Randomization; Systolic blood pressure