{"doi":"10.1002/ana.25793","title":"Ultra‐Early Blood Pressure Reduction Attenuates Hematoma Growth and Improves Outcome in Intracerebral Hemorrhage","abstract":"OBJECTIVE: The aim was to investigate whether intensive blood pressure treatment is associated with less hematoma growth and better outcome in intracerebral hemorrhage (ICH) patients who received intravenous nicardipine treatment ≤2 hours after onset of symptoms. METHODS: A post-hoc exploratory analysis of the Antihypertensive Treatment of Acute Cerebral Hemorrhage 2 (ATACH-2) trial was performed. This was a multicenter, international, open-label, randomized clinical trial, in which patients with primary ICH were allocated to intensive versus standard blood pressure treatment with nicardipine ≤4.5 hours after onset of symptoms. We have included 913 patients with complete imaging and follow-up data in the present analysis. RESULTS: Among the 913 included patients, 354 (38.7%) had intravenous nicardipine treatment initiated within 2 hours. In this subgroup of patients treated within 2 hours, the frequency of ICH expansion was significantly lower in the intensive blood pressure reduction group compared with the standard treatment group (p = 0.02). Multivariable analysis showed that ultra-early intensive blood pressure treatment was associated with a decreased risk of hematoma growth (odds ratio, 0.56; 95% confidence interval [CI], 0.34-0.92; p = 0.02), higher rate of functional independence (odds ratio, 2.17; 95% CI, 1.28-3.68; p = 0.004), and good outcome (odds ratio, 1.68; 95% CI, 1.01-2.83; p = 0.048) at 90 days. Ultra-early intensive blood pressure reduction was associated with a favorable shift in modified Rankin Scale score distribution at 3 months (p = 0.04). INTERPRETATION: In a subgroup of ICH patients with elevated blood pressure given intravenous nicardipine ≤2 hours after onset of symptoms, intensive blood pressure reduction was associated with reduced hematoma growth and improved functional outcome. ANN NEUROL 2020;88:388-395.","journal":"Annals of Neurology","year":2020,"id":51446,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":156,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9608,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":256544,"name":"Andrew D. Warren","orcid":"0000-0002-5832-8178","position":1,"is_corresponding":false},{"id":58037,"name":"Adnan I. Qureshi","orcid":"0000-0003-4962-540X","position":2,"is_corresponding":false},{"id":256545,"name":"Andrea Morotti","orcid":"0000-0002-6558-1155","position":3,"is_corresponding":false},{"id":256546,"name":"Guido J. Falcone","orcid":"0000-0002-6407-0302","position":4,"is_corresponding":false},{"id":256547,"name":"Kevin N. Sheth","orcid":"0000-0003-2003-5473","position":5,"is_corresponding":false},{"id":256548,"name":"Ashkan Shoamanesh","orcid":"0000-0002-2802-1626","position":6,"is_corresponding":false},{"id":256549,"name":"Dar Dowlatshahi","orcid":"0000-0003-1379-3612","position":7,"is_corresponding":false},{"id":256550,"name":"Anand Viswanathan","orcid":"0000-0001-5398-1816","position":8,"is_corresponding":false},{"id":256551,"name":"Joshua N. Goldstein","orcid":"0000-0002-6406-1828","position":9,"is_corresponding":false},{"id":256543,"name":"Qi Li","orcid":"0000-0002-9144-148X","position":0,"is_corresponding":true}],"reference_count":34,"raw_metadata":null,"created_at":"2026-07-18T20:40:28.278215Z","pmid":"32453453","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}