Evidence map›Paper›PMID 40111732›Full record

SynthesisCNS drugs2025

Is the Effect of Intensive Antihypertensive Treatment in Acute Intracerebral Hemorrhage Dependent on Hematoma Volume? A Traditional Meta-analysis of the Effect of Antihypertensive Regimens, a Bayesian Network Meta-analysis of the Mortality of Antihypertensive Drugs and Systematic Review.

Cong Li, Lishuai Li, Zhi Li, Kunhang Li, Xin Shi, Yijun Bao

Abstract readMeta-AnalysisNetwork Meta-AnalysisSystematic Review
In one paragraph

Synthesis in CNS drugs, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Cong Li *Department of Neurosurgery, The Fourth Hospital of China Medical University, No. 4 Chongshandong, Huanggu, Shenyang, 110084, China.
Lishuai Li *Department of Neurosurgery, The Fourth Hospital of China Medical University, No. 4 Chongshandong, Huanggu, Shenyang, 110084, China.
Zhi LiNational Clinical Research Center for Laboratory Medicine, Department of Laboratory Medicine, The First Hospital of China Medical University, Shenyang, 110001, China.
Kunhang LiDepartment of Neurosurgery, The Fourth Hospital of China Medical University, No. 4 Chongshandong, Huanggu, Shenyang, 110084, China.
Xin ShiSchool of Health Management, Institute of Health Sciences, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, China. xshi@cmu.edu.cn.
Yijun BaoDepartment of Neurosurgery, The Fourth Hospital of China Medical University, No. 4 Chongshandong, Huanggu, Shenyang, 110084, China. yjbao@cmu.edu.cn.

Funding

Liaoning Provincial Natural Science Foundation 2020-MS-155
6 · The paper itself

Abstract

BACKGROUND AND 

objectivesIntensive or conventional antihypertensive treatment for acute intracerebral hemorrhage is still controversial. This study aimed to compare those antihypertensive regimens and analyze the efficacy of antihypertensive drugs.

methodsRetrieval was conducted through four databases. Meta-analysis and Bayesian network meta-analysis were performed to evaluate the safety of antihypertensive treatments and the efficacy of antihypertensive drugs.

resultsA total of 9271 patients were included. Intensive strategy showed an advantage in 24-h hematoma enlargement (relative risk, RR = 0.76; 95% confidence intervals, CI = 0.67-0.87; P < 0.0001) and 90-day intracranial rebleeding (RR = 0.71, 95% CI = 0.52-0.96, P = 0.03) compared with conventional strategy. Meanwhile, the 90-day renal insufficiency (RR = 2.31, 95% CI = 1.05-5.05, P = 0.04) and renal failure (RR = 2.42, 95% CI = 1.20-4.86, P = 0.01) were increased. When cerebral hematoma volume was less than 15 ml, intensive strategy had a protective effect on 24-h hematoma enlargement (RR = 0.77, 95% CI = 0.67-0.89, P = 0.0003), but it increased 90-day renal failure (RR = 2.33, 95% CI = 1.07-5.04, P = 0.03). For the volume greater than 15 ml, it enhanced 90-day functional independence (RR = 0.78, 95% CI = 0.65-0.94, P = 0.01) and decreased intracranial rebleeding (RR = 0.68, 95% CI = 0.49-0.94, P = 0.02). Labetalol was the best, with the mortality risk probability of 0.09 and the surface under the cumulative ranking curve of 0.33.

conclusionsThis meta-analysis suggests that for intracerebral hematoma volume greater than 15 ml, intensive antihypertensive treatment can improve functional independence and reduce intracranial bleeding. Labetalol has the best effect among the four antihypertensive regimens studied.

Indexed as

Antihypertensive AgentsCerebral HemorrhageHematomaBayes TheoremHumansAntihypertensive Agents

Identifiers

PMID40111732
PMCPMC11982079

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Registered trials

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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.