Blood pressure levels in the acute phase after intracerebral hemorrhage are associated with mortality in young adults

Background: Intracerebral hemorrhage (ICH) is the most common cause of non-ischemic strokes. Considering high mortality and poor functional status following ICH, we investigated factors that can predict short-term outcome and affect recovery of these patients. Methods: In this prospective descriptive study, 100 patients with non-traumatic ICH were included. Clinical and radiographic data were collected and extent of disability was measured by modified Rankin Scale (mRS) at discharge, 1 week, 1 month, and 3 months after discharge. Results: 32 of 100 cases died at hospital and 6 more expired during 3-month follow-up. Risk factors of in-hospital mortality were warfarin use, surgical intervention, and high ICH score. Functional status of patients significantly improved 3 months after discharge. Factors associated with poor recovery were age older than 70, history of coronary artery disease (CAD), low Glasgow Coma Scale (GCS) at admission, elevated mean arterial pressure (MAP), longer hospitalization, and high ICH score. Conclusion: ICH was associated with high rate of mortality (36%). Warfarin use, surgical intervention, and high ICH score were predictive of mortality during hospitalization and 3-month follow-up. Improvement of functional status began after 1 month and significantly improved 3 months after discharge.

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“…Thus, eliciting patient’s prognosis can direct treating physicians as well as patients’ families toward informed decision-making. 12 …”

Section: Introductionmentioning

confidence: 99%

Mortality and morbidity in patients with spontaneous intracerebral hemorrhage: A single-center experience

Faghih-Jouybari

Raof

Abdollahzade

et al. 2021

CJN

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“…Blood pressure has been considered as an important therapeutic target in acute ICH since it is frequently elevated especially in the acute phase and higher values are associated with an increased risk of early deterioration, hematoma growth, and worse functional outcome ( 16 , 17 ). However, highly rigorous BP reduction has not shown definite benefits in reducing mortality or severe disability in randomized trials ( 3 , 4 ).…”

Section: Discussionmentioning

confidence: 99%

Remote diffusion-weighted imaging lesions and blood pressure variability in primary intracerebral hemorrhage

Peng²,

Zhou³

et al. 2022

Front. Neurol.

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ObjectiveThe aim of this study was to examine the association between remote diffusion-weighted imaging lesions (R-DWILs) and blood pressure variability (BPV) in patients with primary intracerebral hemorrhage (ICH).MethodsWe conducted a retrospective review of a consecutive cohort of 375 patients with primary ICH within 24 h onset. R-DWILs were defined as hyperintensity lesions in DWI remote from the hematoma. Blood pressure recordings were extracted up to 24 h post-admission. BPV was measured using SD, coefficient of variation (CV), and successive variation (SV).ResultsRemote DWI lesions were detected in 65 (17.3%) primary ICH patients. In multivariable logistic regression analysis, parameters of BPV were independently associated with R-DWILs, and the results remained consistent after being adjusted with mean SBP. SD, CV, and SV values in the highest quintile, showed 3- to 8-fold increased risk of R-DWILs, compared with the lowest quintile. ΔSBP demonstrated a significant difference in 2 different predictive models. Max SBP only dictated a significant difference in model 1. Mean SBP, admission SBP, and min SBP, failed to present an association with R-DWILs in model 1 or model 2.ConclusionOur results provided additional evidence that BPV is associated with the development of R-DWILs in primary ICH.

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“…Cerebrovascular disease was a global disease that caused millions of deaths worldwide every year ( Hammond–Haley et al, 2021 ). In recent years, it has been found that hypertension and vasculitis can both cause cerebrovascular diseases (( Mustanoja et al, 2018 ; Lersy et al, 2020 ; and Hou et al, 2021 ). These diseases are often related to the abnormal contraction of blood vessels, which can cause changes in the body’s homeostasis and further aggravate its abnormal contractions.…”

Section: Discussionmentioning

confidence: 99%

Anticonstriction Effect of MCA in Rats by Danggui Buxue Decoction

et al. 2021

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Objective: Danggui Buxue decoction (DBD), consisting of Angelicae Sinensis Radix (ASR) and Astragali Radix (AR), is a famous prescription with the function of antivasoconstriction. This study intends to probe its mechanisms on the relaxation of the middle cerebral artery (MCA).Methods: Vascular tension of rat MCA was measured using a DMT620 M system. First, the identical series of concentrations of DBD, ASR, and AR were added into resting KCl and U46619 preconstricted MCA. According to the compatibility ratio, their dilatation effects were further investigated on KCl and U46619 preconstricted vessels. Third, four K+ channel blockers were employed to probe the vasodilator mechanism on KCl-contracted MCA. We finally examined the effects of DBD, ASR, and AR on the vascular tone of U46619-contracted MCA in the presence or absence of Ca2+.Results: Data suggested that DBD, ASR, and AR can relax on KCl and U46619 precontracted MCA with no effects on resting vessels. The vasodilator effect of ASR was greater than those of DBD and AR on KCl-contracted MCA. For U46619-contracted MCA, ASR showed a stronger vasodilator effect than DBD and AR at low concentrations, but DBD was stronger than ASR at high concentrations. Amazingly, the vasodilator effect of DBD was stronger than that of AR at all concentrations on two vasoconstrictors which evoked MCA. The vasodilator effect of ASR was superior to that of DBD at a compatibility ratio on KCl-contracted MCA at low concentrations, while being inferior to DBD at high concentrations. However, DBD exceeded AR in vasodilating MCA at all concentrations. For U46619-constricted MCA, DBD, ASR, and AR had almost identical vasodilation. The dilation of DBD and AR on KCl-contracted MCA was independent of K+ channel blockers. However, ASR may inhibit the K+ channel opening partially through synergistic interactions with Gli and BaCl2. DBD, ASR, and AR may be responsible for inhibiting [Ca2+]out, while ASR and AR can also inhibit [Ca2+]in.Conclusion: DBD can relax MCA with no effects on resting vessels. The mechanism may be related to ASR’s inhibition of KATP and Kir channels. Meanwhile, the inhibition of [Ca2+]out by DBD, ASR, and AR as well as the inhibition of [Ca2+]in by ASR and AR may contribute to dilate MCA.

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Blood pressure levels in the acute phase after intracerebral hemorrhage are associated with mortality in young adults

Abstract: In young patients with ICH, acute-phase SBP levels ≥160 mmHg are independently associated with increased mortality.

Cited by 15 publications

References 26 publications

Mortality and morbidity in patients with spontaneous intracerebral hemorrhage: A single-center experience

Mortality and morbidity in patients with spontaneous intracerebral hemorrhage: A single-center experience

Remote diffusion-weighted imaging lesions and blood pressure variability in primary intracerebral hemorrhage

Anticonstriction Effect of MCA in Rats by Danggui Buxue Decoction

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