In adults presenting with acute spontaneous intracerebral hemorrhage and a systolic blood pressure between 150 and 220 mm Hg, prompt and carefully controlled blood pressure reduction is a key clinical priority for improving functional outcomes.
Adult patient with acute spontaneous intracerebral hemorrhage (ICH) presenting with a systolic blood pressure of 150–220 mm Hg.
The evidence-based approach involves prompt antihypertensive therapy, carefully titrated to achieve smooth and sustained blood pressure control — avoiding abrupt fluctuations and variability. The full protocol specifies the recommended agent class, titration strategy, duration, and stopping criteria.
SBP 130 to <140 mm Hg, maintained for at least 7 days.
For adult patients with acute spontaneous intracerebral hemorrhage (ICH) who present with SBP between 150 and 220 mm Hg, it can be beneficial to immediately lower SBP to 130 to <140 mm Hg for at least 7 days after ICH to improve functional outcomes but stop antihypertensive medications if SBP <130 mm Hg.
In adults with acute spontaneous ICH requiring acute BP lowering, careful titration to ensure smooth, nonlabile, and sustained control of BP, avoiding peaks and large variability in SBP, can be beneficial for improving functional outcomes.
DOI: 10.1161/CIR.0000000000001356
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