Evidence map›Paper›PMID 41873543›Full record

Trial reportStroke2026

Impact of Ultra-Early Perioperative Antihypertensive Therapy in Acute Intracerebral Hemorrhage.

Tao Liu, Linan Chen, Leibo Liu, Yang Liu, Lu Ma, Laurent Billot, Qiang Li, Zhihao Zhao, Alejandra Malavera, Paula Muñoz-Venturelli and 15 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter StudyPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Stroke, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03209258 (An Investigator Initiated and Conducted, International, Multicenter, Stepped Wedge Cluster Randomized Study of a Care Bundle of Physiological Control Strategies in Acute Intracerebral Hemorrhage), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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.

NCT03209258 nacompletednot on this map

An Investigator Initiated and Conducted, International, Multicenter, Stepped Wedge Cluster Randomized Study of a Care Bundle of Physiological Control Strategies in Acute Intracerebral Hemorrhage

TypeinterventionalSponsorThe George Institute for Global Health, ChinaRan2017 to 2022Enrolled7,067ConditionsCerebral Hemorrhage, Stroke, Hypertension, DiabetesArmsCare bundle of active management, Usual care
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

25 authors.

Tao Liu *George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia (T.L., L.C., L.L., L.B., Q.L., A.M., P.M.-V., L.S., C.S.A., X.C.).ORCID 0000-0002-0506-3356
Linan Chen *George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia (T.L., L.C., L.L., L.B., Q.L., A.M., P.M.-V., L.S., C.S.A., X.C.).ORCID 0000-0002-4926-0191
Leibo LiuGeorge Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia (T.L., L.C., L.L., L.B., Q.L., A.M., P.M.-V., L.S., C.S.A., X.C.).ORCID 0000-0002-7517-0050
Yang LiuDepartment of Neurosurgery, Tianjin Medical University General Hospital, China (Y.L., Z.Z.).ORCID 0009-0004-3027-4122
Lu MaDepartment of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China (L.M., C.Y., X.H.).ORCID 0009-0000-8095-2236
Laurent BillotGeorge Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia (T.L., L.C., L.L., L.B., Q.L., A.M., P.M.-V., L.S., C.S.A., X.C.).ORCID 0000-0002-4975-9793
Qiang LiGeorge Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia (T.L., L.C., L.L., L.B., Q.L., A.M., P.M.-V., L.S., C.S.A., X.C.).
Zhihao ZhaoDepartment of Neurosurgery, Tianjin Medical University General Hospital, China (Y.L., Z.Z.).ORCID 0009-0001-5702-6290
Alejandra MalaveraGeorge Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia (T.L., L.C., L.L., L.B., Q.L., A.M., P.M.-V., L.S., C.S.A., X.C.).ORCID 0000-0002-6084-4315
Paula Muñoz-VenturelliGeorge Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia (T.L., L.C., L.L., L.B., Q.L., A.M., P.M.-V., L.S., C.S.A., X.C.).ORCID 0000-0003-1869-2255
Asita de SilvaClinical Trials Unit, Faculty of Medicine, University of Kelaniya, Colombo, Sri Lanka (A.d.S.).ORCID 0000-0003-2544-6861
Huy Thang NguyenStroke Unit, 115 Hospital, Ho Chi Minh City, Vietnam (H.T.N.).ORCID 0000-0003-1091-9320
Kolawole W WahabDepartment of Medicine, University of Ilorin & University of Ilorin Teaching Hospital, Nigeria (K.W.W.).ORCID 0000-0002-2914-1953
Jeyaraj D PandianNeurology Department, Christian Medical College and Hospital, Ludhiana, India (J.D.P.).ORCID 0000-0003-0028-1968
Mohammad WasayDepartment of Medicine, The Aga Khan University, Karachi, Pakistan (M.W.).ORCID 0000-0003-3750-2613
Octavio M Pontes-NetoDepartment of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Brazil (O.M.P.-N.).ORCID 0000-0003-0317-843X
Rongcai JiangORCID 0009-0004-2257-7668
Carlos AbantoThe Cerebrovascular Disease Research Center, National Institute of Neurological Sciences, Lima, Peru (C.A.).ORCID 0000-0002-6419-4591
Antonio ArauzInstituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, Mexico City, Mexico (A.A.).ORCID 0000-0002-3340-4138
Lili SongGeorge Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia (T.L., L.C., L.L., L.B., Q.L., A.M., P.M.-V., L.S., C.S.A., X.C.).ORCID 0000-0002-6105-1720
Chao YouDepartment of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China (L.M., C.Y., X.H.).ORCID 0000-0002-1783-3688
Craig S AndersonGeorge Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia (T.L., L.C., L.L., L.B., Q.L., A.M., P.M.-V., L.S., C.S.A., X.C.).ORCID 0000-0002-7248-4863
Xin HuDepartment of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China (L.M., C.Y., X.H.).ORCID 0000-0002-6084-1341
Xiaoying ChenGeorge Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia (T.L., L.C., L.L., L.B., Q.L., A.M., P.M.-V., L.S., C.S.A., X.C.).ORCID 0000-0002-8367-542X
INTERACT3 Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly intensive blood pressure (BP) lowering improves outcomes in acute intracerebral hemorrhage, but its perioperative benefit among patients undergoing surgical hematoma evacuation is uncertain. We evaluated whether earlier achievement of intensive BP targets is associated with improved outcomes in this population.

methodsPost hoc secondary analysis of the INTERACT3 (the third Intensive Care Bundle With Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial) pragmatic, international, multicenter, blinded-end point, and stepped-wedge cluster-randomized trial. Among 7036 enrolled intracerebral hemorrhage patients at 121 hospitals, those who underwent surgical hematoma evacuation were included. Patients were categorized by time from hospital arrival to achieving the target systolic BP <140 mm Hg: ≤2 hours versus >2 hours. The primary outcome was 6-month mortality. Key secondary outcomes included death or disability (modified Rankin Scale scores 4-6), modified Rankin Scale score shift, health-related quality-of-life (EuroQol 5-Dimension 3-Level [EQ-5D-3L] domains, visual analog scale, and health utility index), and serious adverse events. Adjusted associations were estimated using Cox, logistic, ordinal logistic, and linear regression models, controlling for age, sex, treatment type, and admission Glasgow Coma Scale.

resultsOf 7036 patients with acute intracerebral hemorrhage, 1506 underwent surgical hematoma evacuation (mean [SD] age, 59.7 [11.8] years; 33.9% women). Overall, there was no statistically significant difference in 6-month mortality between patients who achieved target BP within 2 hours of treatment initiation and those who achieved it after 2 hours (adjusted hazard ratio, 0.81 [95% CI, 0.63-1.04];

conclusionsIn patients with intracerebral hemorrhage undergoing surgical hematoma evacuation, perioperative intensive BP reduction appears safe. Achieving systolic BP <140 mm Hg within 2 hours was associated with better functional and quality-of-life outcomes, and fewer serious adverse events. These time-sensitive associations support prioritizing ultra-early perioperative BP control; confirmatory prospective analyses are warranted. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03209258.

Indexed as

Antihypertensive AgentsCerebral HemorrhagePerioperative CareAgedBlood PressureFemaleHumansMaleMiddle AgedQuality of LifeTreatment OutcomeAntihypertensive Agentsblood pressurecerebral hemorrhageGlasgow Coma Scalehematomaquality of life

Identifiers

PMID41873543
PMCPMC13196860

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Registered trials

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