Evidence map›Paper›PMID 23713578›Full record

Trial reportThe New England journal of medicine2013

Rapid blood-pressure lowering in patients with acute intracerebral hemorrhage.

Craig S Anderson, Emma Heeley, Yining Huang, Jiguang Wang, Christian Stapf, Candice Delcourt, Richard Lindley, Thompson Robinson, Pablo Lavados, Bruce Neal and 12 more

7 registry-linked trialsOpen access · bronzeAbstract readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in The New England journal of medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 7 registered trials, which are not on this map. Cited by 605 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
605citing papers in PubMed, 14 pooled it
80.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00716079 nacompletednot on this map

An International Randomised Controlled Trial to Establish the Effects of Early Intensive Blood Pressure Lowering in Patients With Intracerebral Haemorrhage.

TypeinterventionalSponsorThe George InstituteRan2008 to 2012Enrolled2,839ConditionsIntracerebral Hemorrhage, Stroke, HypertensionArmsBlood pressure management policies
NCT02982655 nacompletednot on this mapstarted 2017, after this paper: background citation

A Multi-center Randomised Controlled Trial to Explore the Ideal Individualized Anti-hypertension Strategies in Patients With Severe Stroke at Acute Stage

TypeinterventionalSponsorXijing HospitalRan2017 to 2018Enrolled500ConditionsSevere Stroke, Acute Stroke, HypertensionArmsIndividualized BP lowering
NCT03129009 naunknown statusnot on this mapstarted 2017, after this paper: background citation

Changes of Hemodynamics and Vital Organ Function in Intracerebral Hemorrhage During Different General Anesthesia

TypeinterventionalSponsorXuzhou Medical UniversityRan2017 to 2018Enrolled90ConditionsBalanced Anesthesia, Intracerebral Hemorrhage, Total Intravenous AnesthesiaArmsTotal intravenous anesthesia group, Balanced anesthesia group
NCT03207100 nacompletednot on this mapstarted 2017, after this paper: background citation

Clinical Study of the Safety and Efficacy of Analgesia-first Minimal Sedation as an Early Antihypertensive Treatment for Spontaneous Intracerebral Hemorrhage

TypeinterventionalSponsorHong YangRan2017 to 2021Enrolled338ConditionsEarly Systolic Blood Pressure Control Rate, Hematoma Growth, Blood Pressure Variability, Healthcare Worker SatisfactionArmsAnalgesia-first minimal sedation, Antihypertensive treatment
NCT04167644 completednot on this mapstarted 2018, after this paper: background citation

Proper Timing of Control of Hypertension and Outcome in Acute Spontaneous Intracerebral Hemorrhage.

TypeobservationalSponsorMansoura University HospitalRan2018 to 2019Enrolled150ConditionsIntra Cerebral Hemorrhage, HypertensionArmsModified Rankin Scale (mRS)
NCT05918705 completednot on this mapstarted 2023, after this paper: background citation

Is the Ratio of Optic Nerve Sheath Diameter to Eyeball Transverse Diameter Correlated with the Prognosis of Sepsis Associated Encephalopathy in Critically Ill Patients

TypeobservationalSponsorZagazig UniversityRan2023 to 2024Enrolled89ConditionsSepsis-associated EncephalopathyArmsUltrasound optic nerve sheath diameter / eyeball transverse diameter ratio
NCT07695220 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Efficacy and Safety of an Early Intensive Blood Pressure-Lowering Strategy Using Remifentanil and Dexmedetomidine in Patients With Spontaneous Intracerebral Hemorrhage: A Multicenter, Prospective, Superiority, Randomized Controlled Trial

TypeinterventionalSponsorThe Third Affiliated Hospital of Southern Medical UniversityRan2026 to 2028Enrolled1,116ConditionsIntracerebral HemorrhageArmsRemifentanil and Dexmedetomidine, Guideline standard care
3 · Its place in the literature

Who cites it

605 citing papers in PubMed, 14 syntheses or guidelines pooled it, 1,570 citations in OpenAlex.

  1. Pooled it
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  9. The Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025).Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Guideline
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  11. Surgery for spontaneous supratentorial intracerebral haemorrhage.The Cochrane database of systematic reviews · 2025
    Pooled it
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  18. Blood pressure variability in the ATACH2 study: evaluating a target range.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
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545 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

22 authors at 10 institutions in 7 countries.

Craig S AndersonGeorge Institute for Global Health, University of Sydney, Sydney, NSW, Australia. canderson@georgeinstitute.org.au
Emma Heeley
Yining Huang
Jiguang Wang
Christian Stapf
Candice Delcourt
Richard Lindley
Thompson Robinson
Pablo Lavados
Bruce Neal
Jun Hata
Hisatomi Arima
Mark Parsons
Yuechun Li
Jinchao Wang
Stephane Heritier
Qiang Li
Mark Woodward
R John Simes
Stephen M Davis
John Chalmers
INTERACT2 Investigators
University of Sydney · AUBaotou Central Hospital · CNJohn Hunter Hospital · AUNational Health and Medical Research Council · AUNIHR Leicester Cardiovascular Biomedical Research Unit · GBPeking University · CNShanghai Jiao Tong University · CNSorbonne Paris Cité · FRUniversity of Chile · CLUniversity of Melbourne · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWhether rapid lowering of elevated blood pressure would improve the outcome in patients with intracerebral hemorrhage is not known.

methodsWe randomly assigned 2839 patients who had had a spontaneous intracerebral hemorrhage within the previous 6 hours and who had elevated systolic blood pressure to receive intensive treatment to lower their blood pressure (with a target systolic level of <140 mm Hg within 1 hour) or guideline-recommended treatment (with a target systolic level of <180 mm Hg) with the use of agents of the physician's choosing. The primary outcome was death or major disability, which was defined as a score of 3 to 6 on the modified Rankin scale (in which a score of 0 indicates no symptoms, a score of 5 indicates severe disability, and a score of 6 indicates death) at 90 days. A prespecified ordinal analysis of the modified Rankin score was also performed. The rate of serious adverse events was compared between the two groups.

resultsAmong the 2794 participants for whom the primary outcome could be determined, 719 of 1382 participants (52.0%) receiving intensive treatment, as compared with 785 of 1412 (55.6%) receiving guideline-recommended treatment, had a primary outcome event (odds ratio with intensive treatment, 0.87; 95% confidence interval [CI], 0.75 to 1.01; P=0.06). The ordinal analysis showed significantly lower modified Rankin scores with intensive treatment (odds ratio for greater disability, 0.87; 95% CI, 0.77 to 1.00; P=0.04). Mortality was 11.9% in the group receiving intensive treatment and 12.0% in the group receiving guideline-recommended treatment. Nonfatal serious adverse events occurred in 23.3% and 23.6% of the patients in the two groups, respectively.

conclusionsIn patients with intracerebral hemorrhage, intensive lowering of blood pressure did not result in a significant reduction in the rate of the primary outcome of death or severe disability. An ordinal analysis of modified Rankin scores indicated improved functional outcomes with intensive lowering of blood pressure. (Funded by the National Health and Medical Research Council of Australia; INTERACT2 ClinicalTrials.gov number, NCT00716079.).

Indexed as

Acute DiseaseAgedAntihypertensive AgentsBlood PressureCerebral HemorrhageDisability EvaluationFemaleHumansHypertensionMaleMiddle AgedSingle-Blind MethodTime FactorsAntihypertensive Agents

Identifiers

PMID23713578
OpenAlexW2114214167

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

and 1 more above

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.