The effects of acute systolic blood pressure levels achieved with continuous intravenous administration of nicardipine for Japanese patients with acute intracerebral hemorrhage on clinical outcomes were determined. A systematic review and individual participant data analysis of articles were performed based on prospective studies involving adults developing hyperacute intracerebral hemorrhage who were treated with intravenous nicardipine. Outcomes included death or disability at 90 days, defined as the modified Rankin Scale score of 4–6, and hematoma expansion, defined as an increase 6 mL or more from baseline to 24 h computed tomography. Of the total 499 Japanese patients (age 64.9 ± 11.8 years, 183 women, initial BP 203.5 ± 18.3/109.1 ± 17.2 mmHg) studied, death or disability occurred in 35.6%, and hematoma expansion occurred in 15.6%. Mean hourly systolic blood pressure during the initial 24 h was positively associated with death or disability (adjusted odds ratio 1.25, 95% confidence interval 1.03–1.52 per 10 mmHg) and hematoma expansion (1.49, 1.18–1.87). These odds ratios were relatively high as compared to the reported ones for overall global patients of this individual participant data analysis [1.12 (95% confidence interval 1.00–1.26) and 1.16 (1.02–1.32), respectively]. In conclusion, lower levels of systolic blood pressure by continuous intravenous nicardipine were associated with lower risks of hematoma expansion and 90-day death or disability in Japanese patients with hyperacute intracerebral hemorrhage. The impact of systolic blood pressure lowering on better outcome seemed to be stronger in Japanese patients than the global ones.
Bibliographical noteFunding Information:
Partly funded by Japan Agency for Medical Research and Development (AMED: JP22lk0201094 and JP22lk0201109).
Partly funded by Japan Agency for Medical Research and Development (AMED: JP22lk0201094 and JP22lk0201109). Adnan I. Qureshi4, Yuko Y. Palesch5, Kazunori Toyoda6, Kazuyuki Nagatsuka6, Masatoshi Koga6, Masafumi Ihara6, Yongjun Wang7, Nobuyuki Sakai8, Takayuki Hara9, Zhimin Wang10, Jiann-Shing Jeng11, Sachin Agarwal12, Kiwon Lee12, Stephan A. Mayer12, M. Fareed K. Suri13, Qaisar A. Shah14, Jawad F. Kirmani15, Adnan I. Qureshi16, Haitham Hussein16, Jill M. Novitzke16, Cathie Witzel16, Bo Connelly16, Saqib A. Chaudhry16, Emily I. Abbott16, Erik T. Maland16, Kathryn A. France16, Basit Rahim16, Zachariah Miller16, Alfredo J. Caceres16, Logan J. Brau16, Mushtaq H. Qureshi16, Jessy K. Thomas16, Mohammad R. Afzal16, Norrita Rech16, Yuko Y. Palesch17, Renee Martin17, Wenle Zhao17, Lydia Foster17, Jaime Speiser17, Catherine Dillon17, Jaemyung Kim17, Cassidy Conner17, Adam Henry17, Kristina Hill17, Kristen Clasen17, Christy Cassarly17, Daniel F. Hanley18, Carlos S. Kase18, J. Ricardo Carhuapoma18, Nichol McBee18, Claudia Moy19, Scott Janis19, J. Claude HemphillIII19, Brian L. Hoh19, Mario Zucharello19, Michael K. Parides19Kazunori Toyoda6, Kazuomi Kario20, Michito Namekawa20, Jyoji Nakagawara21, Kenji Kamiyama21, Eisuke Furui22, Ryo Itabshi22, Yukako Yazawa22, Yoshiaki Shiokawa23, Kazutoshi Nishiyama23, Yasuhiro Hasegawa24, Hisanao Akiyama24, Satoshi Okuda25, Tomoko Noda25, Hioshi Yamagami26, Kenichi Todo26, Kazumi Kimura27, Kensaku Shibazaki27, Yoshiki Yagita27, Yasushi Okada28, Tomonaga Matsushita28, Kazuyuki Nagatsuka6, Takanari Kitazono29, Teruyuki Hirano30, Masatoshi Koga6, Shoji Arihiro6, Shoichiro Sato6, Masaki Naganuma6, Koichiro Maeda6, Mayumi Mori6, Tomohisa Nezu6, Tetsuya Miyagi6, Kaoru Endo6, Masato Osaki6, Junpei Kobayashi6, Takuya Okata6, Yuki Sakamoto6, Eijirou Tanaka6, Haruka Kanai6, Azusa Tokunaga6, Kazuo Minematsu6
© 2022, The Author(s).
- Acute stroke
- Antihypertensive therapy
- Blood pressure
- Intracranial hemorrhage
PubMed: MeSH publication types
- Systematic Review
- Journal Article