02713nas a2200397   4500000000100000008004100001653001100042653000900053653001600062653001700078653001900095653002400114653003300138653001800171653003700189653002800226653001300254653001800267100001900285700002000304700002100324700002200345700001800367700001900385700001300404700001600417700001900433700001800452700001700470700002900487245018800516300001100704490000700715520157900722022001402301       2016                            d10aHumans10aAged10aMiddle Aged10aHypertension10aBlood Pressure10aCerebral Hemorrhage10aPractice Guidelines as Topic10aAcute Disease10aOutcome Assessment (Health Care)10aAntihypertensive Agents10aHematoma10aCritical Care1 aAnderson Craig1 aStapf Christian1 aDelcourt Candice1 aRobinson Thompson1 aLavados Pablo1 aArima Hisatomi1 aWang Xia1 aChalmers J.1 aSato Shoichiro1 aCarcel Cheryl1 aSandset Else1 aINTERACT2 Investigators*00aDegree and Timing of Intensive Blood Pressure Lowering on Hematoma Growth in Intracerebral Hemorrhage: Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial-2 Results.  a1651-30 v473 a<p>
<b>BACKGROUND AND PURPOSE: </b>Degree and timing of blood pressure (BP) lowering treatment in relation to hematoma growth were investigated in the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial-2 (INTERACT2).
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<b>METHODS: </b>INTERACT2 was an international clinical trial of intensive (target systolic BP [SBP], &lt;140 mm Hg) versus guideline-recommended (SBP, &lt;180 mm Hg) BP lowering in 2839 patients within 6 hours of spontaneous intracerebral hemorrhage and elevated SBP (150-220 mm Hg), in which 964 had repeat cranial computed tomography at 24 hours. ANCOVA models assessed categories of SBP reduction and time to target SBP on 24-hour hematoma growth.
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<b>RESULTS: </b>Greater SBP reduction was associated with reduced hematoma growth (13.3, 5.0, and 3.0 mL for &lt;10, 10-20, and ≥20 mm Hg, respectively; P trend&lt;0.001). In the intensive treatment group (n=491), the least mean hematoma growth was in patients who achieved target SBP &lt;1 hour (2.6 mL) versus to those in target at 1 to 6 (4.7 mL) and &gt;6 hours (5.4 mL). The smallest mean absolute hematoma growth (2.0 mL) was in those achieving target SBP 5 to 8 times versus 3 to 4 (3.1 mL) and 0 to 2 times (5.2 mL).
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<b>CONCLUSIONS: </b>Intensive BP lowering with greater SBP reduction, which is achieved quickly and maintained consistently, seems to provide protection against hematoma growth for 24 hours.
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<b>CLINICAL TRIAL REGISTRATION: </b>URL: http://www.clinicaltrials.gov. Unique identifier: NCT00716079.
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