Trial reportAnnals of neurology2020
Ultra-Early Blood Pressure Reduction Attenuates Hematoma Growth and Improves Outcome in Intracerebral Hemorrhage.
Trial report in Annals of neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 86 papers, 5 of them syntheses that pooled it.
What it found
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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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
86 citing papers in PubMed, 5 syntheses or guidelines pooled it, 152 citations in OpenAlex.
- 2025 update to European Stroke Organisation (ESO) guideline on blood pressure management in acute ischaemic stroke and intracerebral haemorrhage.European stroke journal · 2026Guideline
- Prehospital blood pressure lowering in acute hemorrhagic stroke: a systematic review and meta-analysis of randomized controlled clinical trials.European stroke journal · 2026Pooled it
- Early lowering of blood pressure after acute intracerebral haemorrhage: a systematic review and meta-analysis of individual patient data.Journal of neurology, neurosurgery, and psychiatry · 2022Pooled it
- Association of the stress hyperglycemia ratio and clinical outcomes in patients with stroke: A systematic review and meta-analysis.Frontiers in neurology · 2022Pooled it
- Haemostatic therapy in spontaneous intracerebral haemorrhage patients with high-risk of haematoma expansion by CT marker: a systematic review and meta-analysis of randomised trials.Stroke and vascular neurology · 2021Pooled it
- Identifying treatment-responsive patient subgroups in a neutral clinical trial of Intensive blood pressure reduction in acute intracerebral hemorrhage: A post hoc explainable machine learning analysis.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026Trial
- Impact of Ultra-Early Perioperative Antihypertensive Therapy in Acute Intracerebral Hemorrhage.Stroke · 2026Trial
- The Association between Hourly Systolic Blood Pressure Variability and Outcomes in Patients with Intracerebral Hemorrhage is Time-Dependent: Post-hoc Analysis of the ATACH-2 Trial.Neurocritical care · 2026Trial
- Assessing the Clinical Relevance of Blood Pressure Measures in Spontaneous Intracerebral Hemorrhage: A Post Hoc Analysis of ATACH-2.Neurocritical care · 2025Trial
- Optimal Magnitude of Blood Pressure Reduction and Hematoma Growth and Functional Outcomes in Intracerebral Hemorrhage.Neurology · 2025Trial
- Intraventricular Hemorrhage Expansion in the CLEAR III Trial: A Post Hoc Exploratory Analysis.Stroke · 2022Trial
- Magnesium Sulfate and Hematoma Expansion: An Ancillary Analysis of the FAST-MAG Randomized Trial.Stroke · 2022Trial
- Location-Specific Hematoma Volume Predicts Early Neurological Deterioration in Supratentorial ICH.Annals of clinical and translational neurology · 2026Article
- The frequency and predictors of hematoma expansion in wake-up intracerebral hemorrhage.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Blood Pressure Control With Clevidipine Is Associated With Hematoma Volume Reduction in Acute Hypertensive Intracerebral Hemorrhage: A Single-Center Prospective Cohort Study.European journal of neurology · 2026Article
- Article
- Prediction of intracerebral hemorrhage hematoma expansion: value of a novel deep learning system score.European radiology · 2026Article
- Systolic Blood Pressure Reduction with Stability as a New Therapeutic Goal in Patients with Intracerebral Hemorrhage: Results of the Pooled Analysis of ATACH 2 and INTERACT 2 Trials.Neurocritical care · 2026Article
- Influence of spot sign on the association between rapidly achieving blood pressure reduction and intracerebral haemorrhage outcomes.European stroke journal · 2026Article
- Prehospital intensive blood pressure management in intracerebral hemorrhage: current evidence, controversies, and future directions.Frontiers in medicine · 2026Review
26 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 6 institutions in 4 countries.
Funding
Abstract
objectiveThe aim was to investigate whether intensive blood pressure treatment is associated with less hematoma growth and better outcome in intracerebral hemorrhage (ICH) patients who received intravenous nicardipine treatment ≤2 hours after onset of symptoms.
methodsA post-hoc exploratory analysis of the Antihypertensive Treatment of Acute Cerebral Hemorrhage 2 (ATACH-2) trial was performed. This was a multicenter, international, open-label, randomized clinical trial, in which patients with primary ICH were allocated to intensive versus standard blood pressure treatment with nicardipine ≤4.5 hours after onset of symptoms. We have included 913 patients with complete imaging and follow-up data in the present analysis.
resultsAmong the 913 included patients, 354 (38.7%) had intravenous nicardipine treatment initiated within 2 hours. In this subgroup of patients treated within 2 hours, the frequency of ICH expansion was significantly lower in the intensive blood pressure reduction group compared with the standard treatment group (p = 0.02). Multivariable analysis showed that ultra-early intensive blood pressure treatment was associated with a decreased risk of hematoma growth (odds ratio, 0.56; 95% confidence interval [CI], 0.34-0.92; p = 0.02), higher rate of functional independence (odds ratio, 2.17; 95% CI, 1.28-3.68; p = 0.004), and good outcome (odds ratio, 1.68; 95% CI, 1.01-2.83; p = 0.048) at 90 days. Ultra-early intensive blood pressure reduction was associated with a favorable shift in modified Rankin Scale score distribution at 3 months (p = 0.04).
interpretationIn a subgroup of ICH patients with elevated blood pressure given intravenous nicardipine ≤2 hours after onset of symptoms, intensive blood pressure reduction was associated with reduced hematoma growth and improved functional outcome. ANN NEUROL 2020;88:388-395.
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Registered trials
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.