• Junpei Kobayashi, Masatoshi Koga, Eijirou Tanaka, Yasushi Okada, Kazumi Kimura, Hiroshi Yamagami, Satoshi Okuda, Yasuhiro Hasegawa, Yoshiaki Shiokawa, Eisuke Furui, Jyoji Nakagawara, Kazuomi Kario, Takuya Okata, Shoji Arihiro, Shoichiro Sato, Kazuyuki Nagatsuka, Kazuo Minematsu, Kazunori Toyoda, and SAMURAI Study Investigators.
• From the Department of Cerebrovascular Medicine (J.K., E.T., T.O., S.S., K.M., K.T.), Division of Stroke Care Unit (M.K., S.A.), and Department of Neurology (K.N.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Cerebrovascular Medicine, NHO Kyushu Medical Center, Fukuoka, Japan (Y.O.); Department of Stroke Medicine, Kawasaki Medical School, Kurashiki, Japan (K. Kimura); Department of Neurology, Stroke Center, Kobe City Medical Center General Hospital, Kobe, Japan (H.Y.); Department of Neurology, NHO Nagoya Medical Center, Nagoya, Japan (S.O.); Department of Neurology, St Marianna University School of Medicine, Kawasaki, Japan (Y.H.); Department of Neurosurgery and Stroke Center, Kyorin University School of Medicine, Mitaka, Japan (Y.S.); Department of Stroke Neurology, Kohnan Hospital, Sendai, Japan (E.F.); Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan (J.N.); and Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan (K. Kario).
• Stroke. 2014 Mar 1;45(3):868-70.

Background And PurposeA short duration (<24 hours) of antihypertensive therapy (AHT) after acute intracerebral hemorrhage (ICH) may be sufficient because active bleeding generally ceases within several hours. We aimed to determine the association between sequential systolic blood pressure (SBP) levels during AHT and outcomes in ICH patients.MethodsIn 211 hyperacute ICH patients who underwent AHT based on predefined protocol, the mean of hourly SBP (mSBP) measurements was calculated over 1 to 8 hours (first mSBP), 9 to 16 hours (second mSBP), and 17 to 24 hours (third mSBP) after the initiation of AHT. Outcomes included neurological deterioration (72-hour Glasgow Coma Scale decrease ≥2 or National Instititutes of Health Stroke Scale increase ≥4), hematoma expansion (>33%), and unfavorable outcome (3-month modified Rankin Scale score 4-6).ResultsThe median first, second, and third mSBPs were 132, 131, and 137 mm Hg, respectively. A higher first mSBP (odds ratio [OR], 2.41; 95% confidence interval [CI], 1.34-4.69 per 10 mm Hg) or second mSBP (OR, 2.08; 95% CI, 1.20-3.80) was independently associated with neurological deterioration, and a higher second mSBP (OR, 1.40; 95% CI, 1.02-2.00) or third mSBP (OR, 1.45; 95% CI, 1.05-2.05) was associated with unfavorable outcome. None of the mSBPs was associated with hematoma expansion.ConclusionsThe continuation of AHT throughout the initial 24 hours after ICH may improve outcomes.

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