FRIDAY, April 4 (HealthDay News) -- Intravenous treatment to
drastically lower the blood pressure of people who've just suffered
bleeding in the brain may improve their prognosis, a pilot study
suggests.
Intracranial hemorrhage often causes a rapid rise in blood
pressure, which may contribute to further bleeding and the growth
of the hematoma (an area of internal bleeding). This can cause the
patient's condition to deteriorate and increase the risk of
disability or death, according to background information in the
study.
Although it's recommended to lower very high blood pressure as
soon as possible in patients with intracranial hemorrhage, there is
little evidence on when to start treatment or how much to lower
blood pressure. This leads to wide variations in the management of
high blood pressure in these patients.
This study compared intensive blood-pressure lowering treatment
(target systolic blood pressure 140mm Hg) in 203 patients to the
recommended best practice standard strategy (target systolic blood
pressure 180 mm Hg) in 201 patients.
Brain scans conducted 24 hours after the start of treatment
showed hematoma growth of 13.7 percent in the intensive treatment
group, compared with 36.6 percent in the non-intensive group.
There were no differences between the two groups in terms of
harmful side effects, rates of death and disability, or quality of
life for survivors after 90 days.
"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," concluded Dr. Craig Anderson, of the George
Institute for International Health in Sydney, Australia, and
colleagues.
The study was expected to be published in the May issue of
The Lancet Neurology.
In the next phase of the trial, the researchers plan to assess
how the intensive blood pressure-lowering treatment affects death
and dependency in 2,800 intracranial hemorrhage patients
worldwide.
In an accompanying Comment, Dr. Mustapha Ezzeddine, of the
University of Minnesota, wrote that the study provides the best
evidence to date of the safety of this kind of treatment.
However, many questions remain: Do the results apply to other
stroke patients? How early and how long should blood pressure be
controlled? Do different drugs have different effects?
The follow-up studies "are likely to answer some of these
questions and, more importantly, to detect any effect on outcomes,"
Ezzeddine wrote.
More information
The MedlinePlus Medical Encyclopedia has more about
intracranial hemorrhage.