Early Intensive BP Lowering for Patients With Acute Spontaneous ICH Is Safe, Improves Functional Outcomes

Background: Among the limited intervention options to improve outcomes for those suffering an acute spontaneous intracranial hemorrhage (ICH), the question remains as to whether early intensive blood pressure (BP) lowering is safe and effective. Objective: To clarify if acute intensive BP lowering of patients admitted with ICH is safe, reduces hematoma growth, and improves functional outcome. Design: Pooled analysis of 4 randomized controlled INTERACT trials (Intensive Ambulance-Delivered Blood Pressure Reduction in Hyperacute Stroke Trial; NCT00226096; NCT00716079; NCT03209258; and NCT03790800). Participants/Methods: From the 4 international, multicenter INTERACT studies, 11,312 participants were included with 5345 (47.3%) randomized to early intensive BP-lowering treatment (BP <140 mm Hg), and 5967 (52.7%) with guideline-recommended therapy (BP <180 mm Hg). Mean patient age was 63 years, and 64.1% were male. A CT substudy was analyzed in centers with CT perfusion capability. more...