To study(1) the time course of elevated blood pressure (2) effect of antihypertensive treatment on outcome in intracerebral hemorrhage.Design and Method:
Patients of intracerebral hemorrhage occurring within 24hrs and with BP > 140/90mmHg, proven by CT scan, admitted in Medical wards, KGMU, Lucknow were included. Exclusion criteria include traumatic intracerebral hemorrhage, very low general condition [GCS < 4], severe systemic illness or neoplasm, renal failure, chronic liver disease, bleeding diathesis, and unwilling or uncooperative. Patient Evaluation: Detailed history, Physical Examination & CT Scan, MRI. Patients (TOTAL = 74) were randomly divided into two groups: Group1- No regular antihypertensive. Only sublingual Nifedipine 5 mg when required. Group 2- given regular antihypertensive treatment, (Atenolol, Hydrochlorthaizide, Amlodipine and Labetalol.) Target was, SBP 160–180 mm of Hg and DBP 90–110 mm of Hg. NIHSS Score and MRS Score monitored in follow-up.Results:
Both groups were matched statistically for age, sex, Past history, CT findings. The mean SBP, DBP and MAP decrease significantly (p < 0.001) in both groups, except that in group2 it started decreasing from day1. The mean SBP,DBP and MAP of two groups were found similar (p > 0.05) at all periods; though at final evaluation, the mean decrease in SBP,DBP and MAP of group2 was 3–5% higher as compared to group1. In both groups, the mean GCS, NIHSS, MRS scores increase (improve) linearly after the treatments. The improvement (increase) was higher in group2 than group1. After 1 month of follow up, similar proportion of outcomes between the two groups (18/4 vs. 44/8, χ2 = 0.09; p = 0.765) though the favorable outcome (discharged) was 2.8% higher in group1 as compared to group2. The overall survivals(6 months) of two groups was found similar. The volume, midline shift, GCS score, SBP, DBP, MAP, MRS score and NIHSS score significantly associated with final outcomes.Conclusions:
With antihypertensive treatment morbidity improved but not mortality.