Study Supports Rapid and Aggressive Blood Pressure Reduction as a Treatment Option in Patients with Hemorrhagic Stroke.

MINNEAPOLIS -- New results support that treatment for hemorrhagic stroke can be improved by using medication to rapidly reduce blood pressure. Hemorrhagic stroke is a type of stroke that involves bleeding in the brain. About 35,000 patients a year in the United States have hemorrhagic stroke with corresponding high blood pressure. The high blood pressure often leads to more blood leakage, swelling of brain tissue, and increased death rates. The study results suggest that reducing blood pressure decreases the rate of additional bleeding in the brain which may ultimately reduce the high levels of death and disability commonly found in this devastating form of stroke.

The Antihypertensive Treatment of Acute Cerebral Hemorrhage (ATACH) trial, led by world-renown stroke neurologist Adnan I. Qureshi MD, reported the results in the journal Critical Care Medicine. ATACH is a National Institutes of Health-funded study. Patients were enrolled from several hospitals across the nation. The study used an intravenous blood pressure medication called nicardipine to treat patients who arrived at the emergency department within 6 hours of the time symptoms began. Patients were assigned to one of three different target ranges of systolic blood pressure reduction. The dosage of the medication given was tailored to keep the blood pressure in the assigned range.

The results of the ATACH trial provide new encouraging data on low rates of treatment failure, neurological deteriorations within 24 hours, and serious adverse events within 72 hours of stroke onset. Another promising finding was that the rate of death at 3 months after the stroke was lower than expected in all study patients whose systolic blood pressure was reduced with intravenous medication.

Study Coordinator Jill Novitzke RN from the Zeenat Qureshi Stroke Research Center commented that the ATACH study establishes the foundation for larger studies in the future. Rapid blood pressure treatment is a strategy that can be made widely available without specialized equipment or personnel. Furthermore, this strategy may make a major impact on improved outcomes for patients and may also lower healthcare costs associated with hemorrhagic stroke.