Manejo intensivo vs. conservador de la presión arterial en pacientes con hemorragia intracerebral aguda: revisión sistemática y metaanálisis

Abstract

ObjectiveThe aim of this study was to compare intensive (systolic BP < 140 mmHg) versus conventional blood pressure management (systolic BP < 180 mmHg), in patients with acute intracerebral haemorrhage; our clinical outcomes were: mortality, disability, and haematoma expansion more than 30% at 24hours. MethodsWe performed a systematic review and meta-analysis. A search was made in Cochrane central, MEDLINE, and EMBASE databases up 20 July 2016. High-quality randomised controlled trials with intensive blood pressure monitoring versus conventional therapy were chosen. ResultsFive high-quality randomised controlled trials with 4360 patients were included in the Meta-Analyses. The mortality at 90 days showed a RR: 0.98; 95% CI: 0.82-1.16; P=.94, I2= 0%. The disability showed a RR: 1.0; 95% CI: 0.93-1.08; P=.90, I2= 0%. The hematoma expansion more than 30% at 24hours showed a RR: 0.87; 95% CI0.69-1.10; P=.15, I2= 41%. ConclusionIn patients with acute intracerebral haemorrhage, intensive blood pressure management or conventional therapy could be similar when the outcomes measured are: mortality at 90 days, disability (Rankin scale), and haematoma expansion.