Intensive blood pressure lowering after spontaneous intracerebral haemorrhage for secondary stroke prevention (RECAP-ICH): a systematic review and individual participant data meta-analysis.
Xia Wang, Yijie Gao, M J Velasco et al.
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In 30 seconds
This systematic review and individual participant data meta-analysis evaluated the effects of intensive blood pressure-lowering treatment on recurrent stroke in 2944 adults with a history of spontaneous intracerebral haemorrhage. The study found that intensive treatment reduced the hazard of first recurrent stroke compared to control (adjusted HR 0.62, 95% CI 0.48-0.80; p=0.0002), primarily by decreasing recurrent intracerebral haemorrhage events.
Key findings
- Intensive blood pressure-lowering reduced the hazard of first recurrent stroke (adjusted HR 0.62, 95% CI 0.48-0.80; p=0.0002).
- Fewer recurrent intracerebral haemorrhage events occurred in the intensive group (33 [2.2%] vs 81 [5.6%]).
- The mean systolic blood pressure difference was 11.2 mm Hg (95% CI 10.7-11.7) over follow-up.
- The estimated time to achieve a 1% absolute benefit was 6.1 months (95% CI 3.5-14.8).
Why it matters
The findings suggest that intensive blood pressure management can significantly reduce the risk of recurrent strokes in patients with a history of intracerebral haemorrhage, highlighting the importance of aggressive treatment strategies in this population.