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In a recent study published in JAHA, an authoritative journal in the field of cardiovascular disease, researchers looked at the association between blood pressure (BP) and outcomes in patients with different etopathic cerebral hemorrhage (ICH) subsypes.
the prospective multi-center cohort study included 5,656 patients with spontaneous ICH in-hospital between January 2012 and December 2016.
researchers used SMASH-U (structural lesions, medication, amyloid vascular disease, systemic/other diseases, hypertension, unknown sources) to classify ICH's egenesic subtypes.
systolic pressure increase is defined as 140mmHg.
high blood pressure is defined as an increase in BP for 1 month before ICH becomes ill.
outcome of the study was a one-month survival rate and a three-month mortality rate.
the study analyzed 5,380 ICH patients, of whom 4,052 (75.3%) had elevated systolic blood pressure when admitted to the hospital and 3,015 (56.0%) had high blood pressure.
multiple analyses of patients who died at 3 months found significant differences in systolic blood pressure in patients with cerebral amyloid vascular disease (P-lt;0.001), structural lesions (P-lt;0.001) and unidentified-source subspecies (P-0.003) compared to patients with hypertension vascular disease subspecies.
systolic blood pressure was associated with a higher three-month mortality rate in patients with hypertension vascular disease subspecies (trend P=0.013) and unknown source subspecies (Trend P=0.005).
In patients with cerebral amyloid vascular disease, there was a significant negative correlation between the history of hypertension and the three-month mortality rate (correction ratio was 0.37, 95% CI was 0.20-0.65; P.lt;0.001).
same time, the corrected Cox regression showed a reduced risk of survival for 1 month with hypertension in patients with cerebral amyloid vascular disease (the corrected risk ratio was 0.47; 95% CI was 0.24-0.92; P=0.027).
study suggests that the association between BP and ICH outcomes may depend on its subsype, and that cerebral amyloid vascular disease may be pathologically different from other pathological characteristics.
further personalized strategy studies for bucking are needed to validate these results.
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