Abstract T P228: Greater Effect of Early Intensive Blood Pressure Lowering on Hematoma Growth in Non-Chinese Participants in the Interact2 Trial
Background: We aimed to assess the effects of early intensive blood pressure (BP) lowering on hematoma growth separately for Chinese and non-Chinese participants in the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2).
Methods: INTERACT2 was an open, randomised, multicentre clinical trial involving 2839 patients with spontaneous ICH and elevated systolic BP (150-220 mmHg) and capacity to receive intensive BP lowering treatment within 6 hours of onset. Participants were centrally randomized to receive intensive (target systolic <140 mmHg) or standard (target systolic <180 mmHg) BP management using intravenous agents. Vital status and disability were assessed over 90 days. Baseline and 24 hour CT digital images were analysed centrally in 964 (34%).
Results: Compared to non-Chinese participants, the Chinese were significantly younger, had milder clinical severity, less co-morbid diabetes and coronary disease, and were randomised slightly later after the onset of ICH. However, baseline hematoma volumes were similar (median 11 ml). There were also significant differences in medical management. Effects of treatment on mean (95% CI) absolute hematoma growth at 24 hours (adjusted for baseline hematoma volume and time from onset of CT) were: (i) non-Chinese - intensive 2.8 (0.7-4.9) vs standard 6.2 (4.1-8.4), [[Unable to Display Character: ∆]]-3.5 (-6.5-0.5) groups, P=0.02; (ii) Chinese - intensive 3.4 (1.5-5.3) vs standard 2.0 (0.04-3.9), [[Unable to Display Character: ∆]]1.4 (-0.8-3.6) groups, P=0.21.
Conclusions: There was a significantly greater effect of early intensive BP lowering on hematoma growth in non-Chinese participants, which could relate to less effective BP reduction and greater use of background medical therapy including mannitol, in the Chinese participants
Author Disclosures: C. Anderson: None. Y. Huang: None. J. Wang: None. H. Arima: None. E. Heeley: None. X. Wang: None. R. Lindley: None. M. Parsons: None. J. Chalmers: None.
- © 2014 by American Heart Association, Inc.