Early Intensive Blood-Pressure Lowering Improves Recovery in Patients With Acute Intracerebral Haemorrhage

I'm sure your ER doctors are following this trial closely so when you present with this type they will know exactly what to do.  I'm not kidding, its your life this knowledge might save.
http://www.docguide.com/early-intensive-blood-pressure-lowering-improves-recovery-patients-acute-intracerebral-haemorrhage?hash=7e422beb&eid=33488&alrhash=3c9ebc-5aeefe0d7ed0a73e6788dca4998df39c
Written by By C. J. Parkyn, PhD
Individuals with acute spontaneous intracerebral haemorrhage who undergo early intensive blood-pressure (BP) lowering (target systolic BP <140 mmHg) experience improved recovery of physical function and health-related quality-of-life measures compared with those treated to guideline recommended “standard” BP control (target systolic BP <180 mmHg), researchers reported at the 22nd European Stroke Conference (ESC Stroke).

Intensive BP treatment does not result in an increase in the number of deaths in patients with acute intracerebral haemorrhage, added Craig S. Anderson, MD, PhD, University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia. Dr. Anderson presented results of the INTEnsive blood pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT) here on May 29.

Results from the INTERACT1 trial previously suggested that intensive BP lowering could achieve approximately 2 to 4 mL absolute attenuation of haematoma growth, reducing damage and improving recovery. The objective of INTERACT2 was to determine whether more intensive BP lowering using intravenous BP-lowering agents of each physician’s choice improves survival (free of major disability) in patients with acute intracerebral haemorrhage.

Dr. Anderson and colleagues from approximately 140 centres worldwide enrolled 2,839 patients between October 2008 and August 2012. The primary outcome was the number of patients with a poor outcome (death or major disability, defined as scores from 3 to 6 on the modified Rankin Scale [mRS]). The researchers were able to assess a total of 2,794 patients.
At day 90, there was no significant difference between the treatment groups for the primary outcome: 12% of patients in both treatment groups had died (mRS score of 6), whereas 40.0% and 43.6% of patients in the intensive and standard BP treatment groups had severe disability (mRS score 3 to 5). The odds ratio with intensive treatment for the primary outcome was 0.87; 95% confidence interval [CI], 0.75 to 1.01; P = .06).

Better EQ-5D (EuroQol) health questionnaire scores were observed for the intensively treated patients compared with those who received standard treatment (mean score 0.6 vs 0.55; P = .002).

“Early intensive blood-pressure lowering, using widely available therapies, can significantly improve the outcome of this illness,” Dr. Anderson concluded.

The INTERACT2 study is an initiative of The George Institute for Global Health, Sydney, Australia.