Evidence map›Paper›PMID 40394357›Full record

ArticleNeurocritical care2026

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.

Adnan I Qureshi, William Baskett, Renee H Martin, Pashmeen Lakhani, Ibrahim A Bhatti, Hijrah El Sabae, Fawaz Al-Mufti, Joao A Gomes, Ali Seifi, Alejandro A Rabinstein and 4 more

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Article in Neurocritical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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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

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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

14 authors.

Adnan I QureshiZeenat Qureshi Stroke Institute, Columbia, MO, USA.
William BaskettInstitute for Data Science and Informatics, University of Missouri, Columbia, MO, USA.
Renee H MartinDepartment of Public Health Sciences College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
Pashmeen LakhaniDepartment of Neurology, University of Missouri, Columbia, MO, USA.
Ibrahim A BhattiZeenat Qureshi Stroke Institute, Columbia, MO, USA. Ibrahim.a.b@hotmail.com.ORCID 0009-0003-8579-5593
Hijrah El SabaeHAE MedSci Solutions, Irvine, USA.
Fawaz Al-MuftiNew York Medical College, Westchester Medical Center at New York Medical College, New York, NY, USA.
Joao A GomesLerner College of Medicine Cleveland Clinic, Cleveland, OH, USA.
Ali SeifiUniversity of Texas Health at San Antonio, San Antonio, TX, USA.
Alejandro A RabinsteinDepartment of Neurology, Mayo Clinic, Rochester, MN, USA.
Jose I SuarezDivision of Neurosciences Critical Care, The Johns Hopkins School of Medicine, Baltimore, MD, USA.
Thorsten SteinerDepartment of Neurology, Varsisano Klinikum Frankfurt Höchst, Frankfurt, Germany.
Chi-Ren ShyuInstitute for Data Science and Informatics, University of Missouri, Columbia, MO, USA.
Craig S AndersonGeorge Institute for Global Health, Australia, University of New South Wales, Sydney, NSW, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe American Heart Association/American Stroke Association recommends achieving systolic blood pressure (SBP) therapeutic targets within 60 min of initiating treatment for intracerebral hemorrhage (ICH), emphasizing avoidance of "overshoot" correction and SBP fluctuations. We evaluated the prognostic value of "SBP reduction with stability," a novel end point combining controlled blood pressure reduction and maintenance, using data from two large multinational clinical trials.

methodsWe analyzed patients with ICH from Antihypertensive Treatment of Acute Cerebral Hemorrhage 2 and Intensive BP Reduction in Acute Cerebral Hemorrhage Trial 2 trials presenting with initial SBP 150-220 mm Hg. SBP reduction with stability was defined as achieving and maintaining SBP between 130 and 150 mm Hg within the first hour after randomization based on consecutive recordings. Outcomes included functional independence (modified Rankin scale 0-2) at 90 days and neurological deterioration within 24 h, adjusted for potential confounders.

resultsAmong 3,694 patients with ICH (2,781 patients from Intensive BP Reduction in Acute Cerebral Hemorrhage Trial 2 and 913 patients from Antihypertensive Treatment of Acute Cerebral Hemorrhage 2), 1,061 patients (28.7%) achieved SBP reduction with stability within 1 h. Patients had mean age 63.3 ± 12.9 years, baseline SBP 177.14 ± 18.28 mm Hg, and median hematoma volume of 10.78 mL (interquartile range 5.5-19.16). Achieving SBP reduction with stability significantly improved functional independence odds (odds ratio 1.38, 95% confidence interval 1.16-1.64) and reduced neurological deterioration odds (odds ratio 0.68, 95% confidence interval 0.53-0.88) after adjusting for initial SBP, Glasgow Coma Scale, age, sex, stroke history, hypertension, diabetes mellitus, study, ICH location, hematoma volume, and intraventricular hemorrhage presence.

conclusionsOnly 30% of patients with mild-to-moderate ICH achieved SBP reduction with stability within the first hour. This achievement was associated with improved functional outcomes and reduced early neurological deterioration. These findings suggest that SBP reduction with stability represents a valuable therapeutic target for future clinical trials in ICH management.

Indexed as

Antihypertensive AgentsBlood PressureCerebral HemorrhageHypertensionOutcome Assessment, Health CareAgedFemaleHumansMaleMiddle AgedAntihypertensive AgentsClinical trialFunctional outcomeICHStabilitySystolic blood pressure

Identifiers

PMID40394357

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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.