Aggressive Blood Pressure Lowing Therapy in Patients with Acute Intracerebral Hemorrhage is Safe： A Systematic Review and Meta-analysis  

作　　者：Chao Pan Yang Hu Na Liu Ping Zhang You-Ping Zhang Miribanu Aimaiti Hong Deng Ying-Xing Tang Feng Xu Sui-Qiang Zhu Zhou-Ping Tang 

机构地区：[1]Department of Neurology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China

出　　处：《Chinese Medical Journal》2015年第18期2524-2529,共6页中华医学杂志（英文版）

基　　金：This research was supported by grants from the National Natural Science Foundation of China，the Key Clinical Program of the Ministry of Health of China

摘　　要：Background： The influence of blood pressure （BP） lowering on intracerebral hemorrhage （ICH） patients is unclear. To assess the safety and efficacy of aggressive antihypertensive therapies in acute ICH patients, we carried out a systematic review and meta-analysis. Methods： PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and VIP database up to July 2014 were searched. H igh-quality randomized controlled trials were included. Low-quality trials were excluded. Serious adverse events were defined as the primary outcome. The secondary outcomes were hematoma enlargement （HE） at 24 h after onset, mortality, and favorable clinical outcome at 90 days. Results： Four high-quality trials involving a total of 1427 patients met the inclusion criteria and were analyzed. Odds ratios （ORs） of primary outcome was 0.96 （95% confidence interval [CI]： 0.82-1.13, P = 0.61）. ORs of HE at 24 h after onset, mortality and favorable clinical outcome at 90 days were 0.91 （95% CI： 0.72-1.17, P = 0.47）, 0.97 （95% CI： 0.79-1.20, P = 0.81）, 1.13 （95% CI： 0.98-1.30. P = 0.09） respectively. Conclusions： Aggressive BP management policies are safe and might have a potency of reducing HE and improving clinical outcome.Background： The influence of blood pressure （BP） lowering on intracerebral hemorrhage （ICH） patients is unclear. To assess the safety and efficacy of aggressive antihypertensive therapies in acute ICH patients, we carried out a systematic review and meta-analysis. Methods： PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and VIP database up to July 2014 were searched. H igh-quality randomized controlled trials were included. Low-quality trials were excluded. Serious adverse events were defined as the primary outcome. The secondary outcomes were hematoma enlargement （HE） at 24 h after onset, mortality, and favorable clinical outcome at 90 days. Results： Four high-quality trials involving a total of 1427 patients met the inclusion criteria and were analyzed. Odds ratios （ORs） of primary outcome was 0.96 （95% confidence interval [CI]： 0.82-1.13, P = 0.61）. ORs of HE at 24 h after onset, mortality and favorable clinical outcome at 90 days were 0.91 （95% CI： 0.72-1.17, P = 0.47）, 0.97 （95% CI： 0.79-1.20, P = 0.81）, 1.13 （95% CI： 0.98-1.30. P = 0.09） respectively. Conclusions： Aggressive BP management policies are safe and might have a potency of reducing HE and improving clinical outcome.

关 键 词：Antihypertensive Therapy： Blood Pressure： Hematoma Enlargement HYPERTENSION Intracerebral Hemorrhage 

分 类 号：Q813[生物学—生物工程] G354.4[文化科学—情报学]