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(Stroke. 1995;26:21-24.)
© 1995 American Heart Association, Inc.

Articles

Relation Between Blood Pressure and Outcome in Intracerebral Hemorrhage

Bhuvaneswari K. Dandapani, MD; Shuichi Suzuki, MD; Roger E. Kelley, MD; Yolanda Reyes-Iglesias, MD Robert C. Duncan, PhD

From the Departments of Neurology (B.K.D., S.S., R.E.K., Y.R.-I.) and Oncology, Division of Biostatistics (R.C.D.), University of Miami (Fla) School of Medicine.

Correspondence to Roger E. Kelley, MD, Department of Neurology, 1501 NW 9th Ave, Miami, FL 33136.

Background and Purpose Controversy continues to exist regarding optimal blood pressure control in acute hypertensive intracerebral hemorrhage. Persistent marked elevation of the blood pressure can promote further bleeding, increase cerebral blood flow, and raise intracranial pressure. Relative hypotension, on the other hand, may promote hypoperfusion with secondary ischemia. This study was designed to assess outcome in patient groups defined by the degree of elevation in their pretreatment and posttreatment blood pressures.

Methods We retrospectively assessed 87 patients who were categorized according to an initial mean arterial pressure >145 mm Hg (n=34) compared with those with a pressure 145 mm Hg (n=53). We also studied blood pressure control within the first 2 to 6 hours of presentation with subjects categorized according to a mean arterial pressure >125 mm Hg (n=40) or 125 mm Hg (n=47).

Results An improved outcome in both mortality and severe morbidity was observed in the 145 (²=7.0, P<.005) and the 125 mm Hg (²=6.7, P<.005) groups.

Conclusions Markedly elevated blood pressure on admission and persistent inadequate blood pressure control adversely affect the prognosis in hypertensive intracerebral hemorrhage.

Key Words: hypertension • intracerebral hemorrhage • stroke outcome

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