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- Title
Blood pressure burden and outcome in warfarin-related intracerebral hemorrhage.
- Authors
Schlunk, Frieder; Yuchiao Chang; Ayres, Alison; Battey, Thomas; Vashkevich, Anastasia; Raffeld, Miriam; Rost, Natalia; Viswanathan, Anand; Gurol, M. Edip; Schwab, Kristin; Greenberg, Steven M.; Rosand, Jonathan; Goldstein, Joshua N.
- Abstract
Background and purpose: Blood pressure reduction is a promising intervention for acute intracerebral hemorrhage, but clinical trials of this treatment often exclude those with anticoagulant-associated intracerebral hemorrhage, leaving it unclear whether this population might benefit.We examined whether persistently elevated blood pressure values (blood pressure burden) over the first 24 h are associated with hematoma expansion and mortality in anticoagulant-associated intracerebral hemorrhage. Methods: We retrospectively identified consecutive patients with primary anticoagulant-associated intracerebral hemorrhage (warfarin anticoagulation) who presented within 6 h after symptom onset and a matched set of nonanticoagulant- associated intracerebral hemorrhage patients. Associations between 24 h blood pressure burden, hematoma expansion, and mortality were evaluated using univariable and multivariable logistic regression. Results: Sixty-nine anticoagulant-associated intracerebral hemorrhage and 69 matched non-anticoagulant-associated intracerebral hemorrhage patients were included. Hematoma expansion occurred in 25 anticoagulant-associated intracerebral hemorrhage patients (36%) and 15 control patients (22 %; p=0.091). Twenty-four-hour blood pressure burden was in fact lower in anticoagulant-associated intracerebral hemorrhage than in non-anticoagulant-associated intracerebral hemorrhage patients (p=0.033). No association was found in anticoagulant-associated intracerebral hemorrhage and non-anticoagulant-associated intracerebral hemorrhage between BP burden, hematoma expansion, and 30-day mortality. Conclusion: We found no evidence that higher 24 h blood pressure burden is associated with hematoma expansion or mortality in anticoagulant-associated intracerebral hemorrhage.
- Subjects
REGULATION of blood pressure; WARFARIN; ANTICOAGULANTS; HEMATOLOGIC agents; HYPERTENSION; CARDIOVASCULAR disease treatment; CARDIOVASCULAR pharmacology
- Publication
International Journal of Stroke, 2016, Vol 11, Issue 8, p898
- ISSN
1747-4930
- Publication type
Article
- DOI
10.1177/1747493016658300