• Junpeng Ma, Hao Li, Yi Liu, Chao You, Siqing Huang, and Lu Ma.
• Sichuan University, West China Hospital, Department of Neurosurgery, Chengdu, China.
• Turk Neurosurg. 2015 Jan 1; 25 (4): 544-51.

AimElevation of blood pressure (BP) is common after intracerebral hemorrhage (ICH). Early BP treatment may be beneficial after ICH, but the effect of intensive BP lowering on ICH outcomes is not known and no systematic review or meta-analysis was published regarding this issue.Material And MethodsWe conducted a meta-analysis to compare the effect of more versus less intensive BP targets on clinical outcomes in patients with ICH. Mortality, unfavorable outcome and adverse events were analyzed. Meta-analysis was performed in terms of the odds ratio (OR) and 95% confidence interval (CI).ResultsFive eligible studies were included and analyzed, involving 3243 patients to use systolic BP (SBP) < 140 mmHg as target BP and 142 patients to use other BP target in intensive BP target group. The pooled OR of mortality and unfavorable outcome after ICH in intensive BP control group comparing with less intensive BP targets group were 0.99 (95% CI 0.81 to 1.23) and 0.90 (95% CI 0.78 to 1.03) respectively. The pooled OR were 0.97 (95% CI 0.80 to 1.18) for neurological deterioration and 0.83 (95% CI 0.61 to 1.11) for hematoma expansion. There is no difference in other adverse events between two groups.ConclusionAcute lowering of SBP to 140 mmHg is probably beneficial for functional outcome in patients with ICH, but the evidence is still insufficient. Further large multicenter studies are required to enhance the evidence to guide the BP lowering target following ICH.

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