02470nas a2200349   4500000000100000008004100001100001900042700001200061700001500073700001300088700001000101700001900111700001600130700001000146700001500156700001100171700001300182700001100195700001300206700001800219700001200237700001300249700001900262700001600281700001500297245012900312250001500441300001000456490000700466520160100473020004602074       2010                            d1 aArima Hisatomi1 aWang J.1 aParsons M.1 aCheng Y.1 aXu E.1 aMorgenstern L.1 aHeeley Emma1 aLi Y.1 aSkulina C.1 aTao Q.1 aJiang J.1 aTai L.1 aZhang J.1 aWoodward Mark1 aPeng B.1 aHuang Y.1 aAnderson Craig1 aChalmers J.1 aNeal Bruce00aLower treatment blood pressure is associated with greatest reduction in hematoma growth after acute intracerebral hemorrhage  a2010/09/09  a852-80 v563 a<p>
The pilot phase of the Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT) showed that rapid blood pressure (BP) lowering can attenuate hematoma growth in acute intracerebral hemorrhage. We sought to define the systolic BP level associated with greatest attenuation of hematoma growth. INTERACT included 404 patients with computed tomographic-confirmed intracerebral hemorrhage, elevated systolic BP (150 to 220 mm Hg), and capacity to commence BP lowering treatment within 6 hours of onset. Computed tomography was done at baseline and at 24 hours using standardized techniques, with digital images analyzed centrally, blinded to clinical data. Associations of baseline and achieved on-treatment (mean during the first 24 hours) systolic BP levels with the primary outcome of increase in hematoma volume were explored. There were 346 patients with duplicate computed tomographic scans. There was no significant association between baseline systolic BP levels and either the absolute or proportional growth in hematoma volume (P trend=0.26 and 0.12, respectively). By contrast, achieved on-treatment systolic BP levels in the first 24 hours were clearly associated with both absolute and proportional hematoma growth (both P trend=0.03). Maximum reduction in hematoma growth occurred in the one third of participants with the lowest on-treatment systolic BP levels (median: 135 mm Hg). Intensive BP reduction to systolic levels between 130 and 140 mm Hg is likely to provide the maximum protection against hematoma growth after intracerebral hemorrhage.
</p>
  a1524-4563 (Electronic)0194-911X (Linking)