Outcomes of Intensive Systolic Blood Pressure Reduction in Patients with Intracerebral Hemorrhage and Excessively High Initial Systolic Blood Pressure: Post Hoc Analysis of a Randomized Clinical Trial

Abstract

Current guidelines from the American Heart Association and American Stroke Association call for intensive and aggressive blood pressure control in patients presenting with spontaneous intracerebral hemorrhage (ICH). In patients with systolic blood pressure (SBP) between 150 and 220 mmHg, lowering SBP to 140 mmHg is considered safe and is associated with improved functional outcomes. For patient with systolic blood pressures greater than 220mmHg, it is recommended to use continuous intravenous medications and frequent blood pressure monitoring to aggressively lower blood pressures, though there are no specific goal parameters recommended and inadequate data to evaluate the safety of such intensive blood pressure control.