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Early blood pressure management in hemorrhagic stroke: a meta-analysis

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Abstract

The aim of the present meta-analysis was to evaluate the outcomes and effects of different systolic blood pressure (SBP) lowering in patients with hemorrhagic stroke using data from randomized controlled trials. A total of 2592 records were identified for this meta-analysis. We finally included 8 studies (6119 patients; mean age 62.8 ± 13.0, 62.7% men). No evidence of heterogeneity between estimates (I2 = 0% < 50%, P = 0.26), or publication bias in the funnel plots (P = 0.065, Egger statistical test) was detected. Death or major disability rates were similar between patients with intensive BP-lowering treatment (SBP < 140 mmHg) and those receiving guideline BP-lowering treatment (SBP < 180 mmHg). Intensive BP-lowering treatment may have a better functional outcome, but the results were not significantly different (log RR = − 0.03, 95% CI: − 0.09 to 0.02; P = 0.55). Intensive BP-lowering treatment tended to be associated with lower early hematoma growth compared with guideline treatment (log RR = − 0.24, 95% CI − 0.38, − 0.11; P < 0.001). Intensive BP-lowering helps reduce hematoma enlargement in the early stage of acute hemorrhagic stroke. However, this observation did not translate into functional outcomes. Further research is needed to clarify the specific scope and time of blood pressure reduction.

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Data availability

The data are deidentifed and collected from the studies published online, it will be made available upon request.

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Acknowledgements

The author thanks the patients who originally signed the informed consent form and the doctors in the participating center who helped to collect the original data.

Funding

This work was supported by the National Natural Science Foundation of China (82271306, 81971132) and grants from the Young Elite Scientist Sponsorship Program by the China Association for Science and Technology (YESS20200178); the Sichuan Science and Technology Program (2021ZYD0106, 2021YJ0430, 2023YFH0069, 2023NSFSC0028, 2022YFS0615); Luzhou Government-Southwest Medical University Strategic Cooperation Project and of Southwest Medical University Project (2020LZXNYDJ33, 2021LZXNYD-P01, 2021ZKZD013, 2021ZKQN050).

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Authors and Affiliations

  1. Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, No. 25 of Taiping Street, Luzhou, 646000, Sichuan, China

    Kuangyang Yu, Yuxuan Sun, Jianhua Peng & Yong Jiang

  2. Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China

    Kecheng Guo, Jianhua Peng & Yong Jiang

  3. Institute of Epigenetics and Brain Science, Southwest Medical University, Luzhou, 646000, China

    Jianhua Peng & Yong Jiang

  4. Sichuan Clinical Research Center for Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China

    Jianhua Peng

  5. Academician (Expert) Workstation of Sichuan Province, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China

    Yong Jiang

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  1. Kuangyang Yu
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Correspondence to Jianhua Peng or Yong Jiang.

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Yu, K., Sun, Y., Guo, K. et al. Early blood pressure management in hemorrhagic stroke: a meta-analysis. J Neurol 270, 3369–3376 (2023). https://doi.org/10.1007/s00415-023-11654-w

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  • DOI: https://doi.org/10.1007/s00415-023-11654-w

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