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Therapeutic Variation in Lowering Blood Pressure: Effects on Intracranial Pressure in Acute Intracerebral Haemorrhage

journal contribution
posted on 15.03.2021, 09:54 by M Kadicheeni, TG Robinson, P Divall, AR Parry-Jones, JS Minhas
Introduction
Intracerebral haemorrhage (ICH) is associated with high morbidity and mortality. Blood pressure (BP) control is one of the main management strategies in acute ICH. Limited data currently exist regarding intracranial pressure (ICP) in acute ICH. The relationship between BP lowering and ICP is yet to be fully elucidated.

Methods
We conducted a systematic review to investigate the effects of BP lowering on ICP in acute ICH. The study protocol was registered on PROSPERO (CRD42019134470).

Results
Following PRISMA guidelines, MEDLINE, EMBASE and CENTRAL were searched for studies on ICH with BP and ICP or surrogate measures. 1096 articles were identified after duplicates were removed; 18 studies meeting the inclusion criteria. Dihydropyridine calcium channel blockers (CCBs) were the most common agent used to lower BP, but had a varying effect on ICP. Other BP-lowering agents used also had a varying effect on ICP.

Discussion and Conclusion
Further work, including large observational or randomized interventional studies, is needed to develop a better understanding of the effect of BP lowering on ICP in acute ICH, which will assist the development of more effective management strategies.

Trial Registration
The study protocol was registered on PROSPERO (CRD42019134470) on 29/05/2019.

History

Citation

High Blood Press Cardiovasc Prev 28, 115–128 (2021). https://doi.org/10.1007/s40292-021-00435-z

Author affiliation

Department of Cardiovascular Sciences

Version

AM (Accepted Manuscript)

Published in

High Blood Pressure and Cardiovascular Prevention

Volume

28

Pagination

115-128

Publisher

Springer Science and Business Media LLC

issn

1120-9879

eissn

1179-1985

Acceptance date

03/02/2021

Copyright date

2021

Available date

18/02/2022

Spatial coverage

New Zealand

Language

eng