The Pharmaceutical Journal
Vol 280 No 7497 p427
12 April 2008

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Intensive reduction of blood pressure is protective post intracerebral haemorrhage

Lowering the blood pressure of individuals who have just had an intracerebral haemorrhage to below that specified by existing guidelines appears to reduce haematoma growth (Lancet Neurology, 5 April 2008).

Australian and Chinese researchers compared an intensive BP-lowering strategy (target systolic BP 140mmHg) in 203 individuals with a standard strategy (target systolic BP 180mmHg) in 201 people with spontaneous intracerebral haemorrhage.

Computerised tomography revealed that haematoma growth was 13.7 per cent in the intensive treatment group compared with 36.3 per cent in the non-intensive group after 24 hours (difference 22.6 per cent, 95 per cent confidence interval 0.6 to 44.5 per cent; P=0.04). Adverse events due to treatment or adverse secondary clinical outcomes were similar for both groups at 90 days.

The authors conclude: “Because intravenous treatment to lower blood pressure is relatively straightforward, is not hazardous, and is of low cost, if applied widely these effects could translate into major absolute benefits.”