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.
