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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Acute Blood Pressure and Outcome After Intracerebral Hemorrhage: The VISTA-ICH Cohort
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Acute Blood Pressure and Outcome After Intracerebral Hemorrhage: The VISTA-ICH Cohort

机译：脑出血后急性血压和结果：Vista-Ich Cohort

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Background: Recent clinical trials suggest that it is safe to acutely lower systolic blood pressure (BP) to 140 mm Hg after ICH, but uncertainty remains regarding optimal management. We sought to better define the link between BP and outcome in ICH patients using data from the Virtual International Stroke Trials Archive (VISTA). Methods: We performed a retrospective analysis of patients of the VISTA-ICH trials. We measured the strength of association between systolic and diastolic BP various components at different timepoints with unfavorable 3 month-outcome, defined as death or moderate-to-severe disability at 3 months (mRS of 4-6), after adjustment for known confounders. We also dichotomized BP values obtained at 24 h at different thresholds to better define an optimal treatment target. The association of BP with hematoma expansion (HE) was also analyzed. Results: A total of 384 patients were included. Higher BP at 24 hours was associated with unfavorable outcome for systolic BP (OR 1.16, 95% C.I. 1.07-1.25), pulse pressure (OR 1.13, 95% C.I. 1.03-1.24), and diastolic BP (OR 1.11, 95% C.I. 1.01-1.23) per 10 mm Hg increment. The association between higher BP at 24 h and unfavorable outcome remained significant down to >140 mm Hg. Elevated systolic BP at 24 h was also associated with HE (OR 1.11, 95% C.I. 1.02-1.21 per 10 mm Hg increment). Conclusion: Elevated BP after ICH at 24 h is associated with poor outcome. Our results support the practice of targeting a systolic BP of 140 mm Hg.
机译：背景：最近的临床试验表明，在脑出血后急性降低收缩压（BP）至140毫米汞柱是安全的，但关于最佳管理仍不确定。我们试图利用虚拟国际中风试验档案（VISTA）中的数据，更好地定义脑出血患者血压与预后之间的联系。方法：我们对VISTA-ICH试验的患者进行回顾性分析。在对已知混杂因素进行调整后，我们测量了不同时间点收缩压和舒张压各成分与不良3个月结局之间的关联强度，不良3个月结局定义为3个月时死亡或中重度残疾（mRS为4-6）。我们还将24小时在不同阈值下获得的血压值二分法，以更好地确定最佳治疗目标。还分析了血压与血肿扩大（HE）的关系。结果：共纳入384例患者。24小时血压升高与收缩压（OR 1.16，95%CI.1.07-1.25）、脉压（OR 1.13，95%CI.1.03-1.24）和舒张压（OR 1.11，95%CI.1.01-1.23）每增加10毫米汞柱相关。24小时血压升高与不良预后之间的相关性在小于140毫米汞柱时仍然显著。24小时收缩压升高也与HE有关（或1.11，95%C.I.每10毫米汞柱增量1.02-1.21）。结论：脑出血后24小时血压升高与不良预后相关。我们的结果支持以140毫米汞柱的收缩压为目标的实践。

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