Page 125 - Read Online

Akinci et al. Vessel Plus 2021;5:56 Vessel Plus
DOI: 10.20517/2574-1209.2021.20

Review Open Access

An overview of acute hypertensive response

following intracerebral hemorrhage: implifications
for clinical practice

Yasemin Akinci, Adnan I. Qureshi

Zeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, MO 65212, USA.
Correspondence to: Dr. Adnan I. Qureshi, Zeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri,
Columbia, MO 65212, USA. E-mail: qureshai@gmail.com
How to cite this article: Akinci Y, Qureshi AI. An overview of acute hypertensive response following intracerebral hemorrhage:
implifications for clinical practice. Vessel Plus 2021;5:56. https://dx.doi.org/10.20517/2574-1209.2021.20
Received: 2 Feb 2021 First Decision: 17 Mar 2021 Revised: 19 Mar 2021 Accepted: 20 Apr 2021 Published: 8 Dec 2021

Academic Editor: Elisa F. M. Ciceri Copy Editor: Yue-Yue Zhang Production Editor: Yue-Yue Zhang

Abstract
The acute hypertensive response, elevated blood pressure in the acute phase of intracerebral hemorrhage, is very
common and is associated with hematoma expansion, cerebral edema formation, intracranial pressure elevation,
and poor long-term outcomes. This has led to the acceptance of antihypertensive treatment of acute hypertensive
response as a mainstay of intacerebral hemorrhage management to reduce hematoma expansion and the
associated disability and mortality. Intensive lowering of systolic blood pressure in the acute phase of intracerebral
hemorrhage with varying intensity of systolic blood pressure reduction has been evaluated in several clinical trials.
Some of these trials showed little benefit with intensive systolic blood pressure reduction compared with moderate
or standard blood pressure reduction, while some showed no benefit and despite the large amount of literature,
optimal approaches are not yet clear. In this review article, we summarized the current knowledge of the
mechanisms underlying acute hypertensive response and the recent guidelines on the treatment of the acute
hypertensive response provided by professional organizations and results of clinical trials and discussed
incorporation of these concepts into clinical practice.

Keywords: Acute hypertensive response, intracerebral hemorrhage, hematoma expansion, blood pressure
reduction, stroke

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

www.vpjournal.net