Management of Acute Hypertensive Response in Intracerebral Hemorrhage Patients After ATACH-2 Trial

Shahram Majidi, Jose Suarez, Adnan I. Qureshi

Research output: Contribution to journalReview article

Abstract

Acute hypertensive response is elevation of systolic blood pressure (SBP) in the first 24 h after symptom onset which is highly prevalent in patients with intracerebral hemorrhage (ICH). Observational studies suggested association between acute hypertensive response and hematoma expansion, peri-hematoma edema and death and disability, and possible reduction in these adverse outcomes with treatment of acute hypertensive response. Recent clinical trials have focused on determining the clinical efficacy of early intensive SBP reduction in ICH patients. The Antihypertensive Treatment of Acute Cerebral Hemorrhage (ATACH-2) trial was the latest phase 3 randomized controlled multicenter clinical trial aimed to study the efficacy of early intensive reduction of SBP in ICH patients. In this review article, we summarize the results of recent clinical trials, treatment principles based on the latest guidelines, and the anticipated interpretation and incorporation of ATACH-2 trial results in clinical practice.

Original languageEnglish (US)
Pages (from-to)249-258
Number of pages10
JournalNeurocritical Care
Volume27
Issue number2
DOIs
StatePublished - Oct 1 2017
Externally publishedYes

Keywords

  • Acute hypertensive response
  • Clinical trial
  • Death
  • Disability
  • Hematoma expansion
  • Intracerebral hemorrhage
  • Randomization
  • Systolic blood pressure

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine

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