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Blood Pressure Lowering in Hemorrhagic Stroke Studied

Treatment well tolerated, more research needed

TUESDAY, April 8 (HealthDay News) -- Early intensive blood pressure-lowering therapy in patients with acute intracerebral hemorrhage appears safe and may decrease hematoma size, but more research is needed to see if this strategy improves outcomes, according to research published online April 7 in The Lancet Neurology.

Craig S. Anderson, Ph.D., of the University of Sydney in Australia, and colleagues studied the safety and efficacy of early blood pressure-lowering in acute intracerebral hemorrhage as part of a run-in phase to a larger trial. In all, 404 patients with acute intracerebral hemorrhage and elevated systolic blood pressure were randomized to early intensive blood pressure-lowering (target systolic pressure of 140 mm Hg) or standard blood pressure management (target systolic pressure of 180 mm Hg). The primary outcome studied was change in hematoma volume at 24 hours.

Mean proportional hematoma growth was 13.7 percent in the intensive group compared to 36.3 percent in the standard group, the researchers report. The adjusted relative risk of hematoma growth was 36 percent lower in the intensive group than in the guideline group. There was no difference between groups in risk of adverse events or secondary clinical outcomes at 90 days, the report indicates.

"Early intensive blood pressure-lowering treatment is clinically feasible, well tolerated, and seems to reduce hematoma growth in intracerebral hemorrhage. A large randomized trial is needed to define the effects on clinical outcomes," the authors conclude.

Several study authors report receiving consultant and lecture fees and grant support from various pharmaceutical companies.

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