Impact of Uncontrolled Hypertension at 3 Months After Intracerebral Hemorrhage
Background Survivors of intracerebral hemorrhage (ICH) are at high risk for recurrent stroke, which is associated with blood pressure control. Because most recurrent stroke events occur within 12 to 18 months of the index ICH, rapid blood pressure control is likely to be crucial. We investigated the...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-06-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.120.020392 |
| _version_ | 1811275169873788928 |
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| author | Alessandro Biffi Kay‐Cheong Teo Juan Pablo Castello Jessica R. Abramson Ian Y. H. Leung William C. Y. Leung Yujie Wang Christina Kourkoulis Evangelos Pavlos Myserlis Andrew D. Warren Jonathan Henry Koon‐Ho Chan Raymond T. F. Cheung Shu‐Leong Ho Christopher D. Anderson M. Edip Gurol Anand Viswanathan Steven M. Greenberg Kui‐Kai Lau Jonathan Rosand |
| author_facet | Alessandro Biffi Kay‐Cheong Teo Juan Pablo Castello Jessica R. Abramson Ian Y. H. Leung William C. Y. Leung Yujie Wang Christina Kourkoulis Evangelos Pavlos Myserlis Andrew D. Warren Jonathan Henry Koon‐Ho Chan Raymond T. F. Cheung Shu‐Leong Ho Christopher D. Anderson M. Edip Gurol Anand Viswanathan Steven M. Greenberg Kui‐Kai Lau Jonathan Rosand |
| author_sort | Alessandro Biffi |
| collection | DOAJ |
| description | Background Survivors of intracerebral hemorrhage (ICH) are at high risk for recurrent stroke, which is associated with blood pressure control. Because most recurrent stroke events occur within 12 to 18 months of the index ICH, rapid blood pressure control is likely to be crucial. We investigated the frequency and prognostic impact of uncontrolled short‐term hypertension after ICH. Methods and Results We analyzed data from Massachusetts General Hospital (n=1305) and the University of Hong Kong (n=523). We classified hypertension as controlled, undertreated, or treatment resistant at 3 months after ICH and determined the following: (1) the risk factors for uncontrolled hypertension and (2) whether hypertension control at 3 months is associated with stroke recurrence and mortality. We followed 1828 survivors of ICH for a median of 46.2 months. Only 9 of 234 (4%) recurrent strokes occurred before 3 months after ICH. At 3 months, 713 participants (39%) had controlled hypertension, 755 (41%) had undertreated hypertension, and 360 (20%) had treatment‐resistant hypertension. Black, Hispanic, and Asian race/ethnicity and higher blood pressure at time of ICH increased the risk of uncontrolled hypertension at 3 months (all P<0.05). Uncontrolled hypertension at 3 months was associated with recurrent stroke and mortality during long‐term follow‐up (all P<0.05). Conclusions Among survivors of ICH, >60% had uncontrolled hypertension at 3 months, with undertreatment accounting for the majority of cases. The 3‐month blood pressure measurements were associated with higher recurrent stroke risk and mortality. Black, Hispanic, and Asian survivors of ICH and those presenting with severe acute hypertensive response were at highest risk for uncontrolled hypertension. |
| first_indexed | 2024-04-12T23:33:15Z |
| format | Article |
| id | doaj.art-e908d8ed84ee4ce1ae40653e46e63e14 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-12T23:33:15Z |
| publishDate | 2021-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-e908d8ed84ee4ce1ae40653e46e63e142022-12-22T03:12:14ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-06-01101110.1161/JAHA.120.020392Impact of Uncontrolled Hypertension at 3 Months After Intracerebral HemorrhageAlessandro Biffi0Kay‐Cheong Teo1Juan Pablo Castello2Jessica R. Abramson3Ian Y. H. Leung4William C. Y. Leung5Yujie Wang6Christina Kourkoulis7Evangelos Pavlos Myserlis8Andrew D. Warren9Jonathan Henry10Koon‐Ho Chan11Raymond T. F. Cheung12Shu‐Leong Ho13Christopher D. Anderson14M. Edip Gurol15Anand Viswanathan16Steven M. Greenberg17Kui‐Kai Lau18Jonathan Rosand19Department of Neurology Massachusetts General Hospital Boston MADepartment of Medicine Queen Mary Hospital LKS Faculty of Medicine The University of Hong Kong Hong Kong SARDepartment of Neurology Massachusetts General Hospital Boston MADepartment of Neurology Massachusetts General Hospital Boston MADepartment of Medicine Queen Mary Hospital LKS Faculty of Medicine The University of Hong Kong Hong Kong SARDepartment of Medicine Queen Mary Hospital LKS Faculty of Medicine The University of Hong Kong Hong Kong SARDepartment of Medicine Queen Mary Hospital LKS Faculty of Medicine The University of Hong Kong Hong Kong SARDepartment of Neurology Massachusetts General Hospital Boston MADepartment of Neurology Massachusetts General Hospital Boston MADepartment of Neurology Massachusetts General Hospital Boston MADepartment of Neurology Massachusetts General Hospital Boston MADepartment of Medicine Queen Mary Hospital LKS Faculty of Medicine The University of Hong Kong Hong Kong SARDepartment of Medicine Queen Mary Hospital LKS Faculty of Medicine The University of Hong Kong Hong Kong SARDepartment of Medicine Queen Mary Hospital LKS Faculty of Medicine The University of Hong Kong Hong Kong SARDepartment of Neurology Massachusetts General Hospital Boston MADepartment of Neurology Massachusetts General Hospital Boston MADepartment of Neurology Massachusetts General Hospital Boston MADepartment of Neurology Massachusetts General Hospital Boston MADepartment of Medicine Queen Mary Hospital LKS Faculty of Medicine The University of Hong Kong Hong Kong SARDepartment of Neurology Massachusetts General Hospital Boston MABackground Survivors of intracerebral hemorrhage (ICH) are at high risk for recurrent stroke, which is associated with blood pressure control. Because most recurrent stroke events occur within 12 to 18 months of the index ICH, rapid blood pressure control is likely to be crucial. We investigated the frequency and prognostic impact of uncontrolled short‐term hypertension after ICH. Methods and Results We analyzed data from Massachusetts General Hospital (n=1305) and the University of Hong Kong (n=523). We classified hypertension as controlled, undertreated, or treatment resistant at 3 months after ICH and determined the following: (1) the risk factors for uncontrolled hypertension and (2) whether hypertension control at 3 months is associated with stroke recurrence and mortality. We followed 1828 survivors of ICH for a median of 46.2 months. Only 9 of 234 (4%) recurrent strokes occurred before 3 months after ICH. At 3 months, 713 participants (39%) had controlled hypertension, 755 (41%) had undertreated hypertension, and 360 (20%) had treatment‐resistant hypertension. Black, Hispanic, and Asian race/ethnicity and higher blood pressure at time of ICH increased the risk of uncontrolled hypertension at 3 months (all P<0.05). Uncontrolled hypertension at 3 months was associated with recurrent stroke and mortality during long‐term follow‐up (all P<0.05). Conclusions Among survivors of ICH, >60% had uncontrolled hypertension at 3 months, with undertreatment accounting for the majority of cases. The 3‐month blood pressure measurements were associated with higher recurrent stroke risk and mortality. Black, Hispanic, and Asian survivors of ICH and those presenting with severe acute hypertensive response were at highest risk for uncontrolled hypertension.https://www.ahajournals.org/doi/10.1161/JAHA.120.020392hypertensionintracerebral hemorrhagestroke |
| spellingShingle | Alessandro Biffi Kay‐Cheong Teo Juan Pablo Castello Jessica R. Abramson Ian Y. H. Leung William C. Y. Leung Yujie Wang Christina Kourkoulis Evangelos Pavlos Myserlis Andrew D. Warren Jonathan Henry Koon‐Ho Chan Raymond T. F. Cheung Shu‐Leong Ho Christopher D. Anderson M. Edip Gurol Anand Viswanathan Steven M. Greenberg Kui‐Kai Lau Jonathan Rosand Impact of Uncontrolled Hypertension at 3 Months After Intracerebral Hemorrhage Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease hypertension intracerebral hemorrhage stroke |
| title | Impact of Uncontrolled Hypertension at 3 Months After Intracerebral Hemorrhage |
| title_full | Impact of Uncontrolled Hypertension at 3 Months After Intracerebral Hemorrhage |
| title_fullStr | Impact of Uncontrolled Hypertension at 3 Months After Intracerebral Hemorrhage |
| title_full_unstemmed | Impact of Uncontrolled Hypertension at 3 Months After Intracerebral Hemorrhage |
| title_short | Impact of Uncontrolled Hypertension at 3 Months After Intracerebral Hemorrhage |
| title_sort | impact of uncontrolled hypertension at 3 months after intracerebral hemorrhage |
| topic | hypertension intracerebral hemorrhage stroke |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.120.020392 |
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