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Akinci et al. Vessel Plus 2021;5:56 https://dx.doi.org/10.20517/2574-1209.2021.20 Page 9 of 20

diltiazem, patients patients (4-6) at outcome outcome
uradipil three event event
months
post
randomiza
tion
Neutral ATACH ICH SBP ≥ 170 6 h Nicardipin 90 ± 15 Cohort 1: 18 patients, target SBP of 170-200 mmHg Treatment Rates Rates
[54,58]
, patients e days Cohort 2: 20 patients, target SBP of 140-170 mmHg failure, were 21% were 31%
2010 Cohort 3: 22 patients, target SBP of 110-140 mmHg neurologic for for
Mean time from symtom onset to initiating treatment was 3.94 h, 4.13 h and 4.44 h, deteriorati hematom hematom
respectively and the goals were achieved in 90% of the patients by 2 h ons within a a
24 h, and expansion expansion
SAE and 35% and 48%
within 72 for poor for poor
h three- three-
month month
outcome outcome

Neutral ENOS Ischemic SBP 140- 48 h Transder 90 days GTN group: 310 patients Mortality Median Median
[64,65]
but, , or 220 mal No GTN group: 319 patients rate and mRS mRS
secondar 2015 hemorrha glyceryl Time from onset to treatment was 25.2 ± 13.1 h in the GTN group, 25.1 ± 12.9 h in the no GTN mRS at 3 grade of 3 grade of 3
gic stroke
months
group
(IQR 2)
trinitrate
(IQR 2)
y analysis patients Baseline BP was 172/93 mmHg and significantly lower in GTN group (-7.5/-4.2 mmHg) on post
supporte day 1 randomiza
d tion
Arguing/ RIGHT- Ischemic SBP ≥ 120 4 h Transder 90 days GTN group: 74 patients mRS at 90 Mean Mean
[73]
against 2 , 2019 or mal Sham group: 71 patients days post mRS mRS
hemorrha glyceryl Median SBP was 176 ± 27 mmHg, mean time from onset to treatment was 74 (45-110) min, randomiza grade of grade of
gic stroke trinitrate BP was lower in the GTN group by admission to hospital (mean, -4.4/-3.5 mmHg) tion 4.9 (± 1.4) 4.3 (± 1.6)
patients
ATACH: Antihypertensive Treatment of Acute Cerebral Hemorrhage; BP: blood pressure; CBF: cerebral blood flow; CT: computerized tomography; ENOS: efficacy of nitric oxide in stroke; ICH: intracerebral
hemorrhage; ICH ADAPT: intracerebral hemorrhage acutely decreasing arterial pressure trial; INTERACT: Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial; IQR: interquartile range; MAP:
mean arterial pressure; MMP-9: matrix metalloproteinase-9; mRS: modified Rankin scale; NIHSS: National Institutes of Health Stroke Scale; RIGHT: Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke
Trial; SAE: serious adverse event; SBP: systolic blood pressure.

[52]
Koch et al. , 2008
Koch et al. investigated the feasibility and safety of aggressive BP lowering in this prospective, randomized, single-center study. They used MAP instead of
[52]
SBP in line with AHA guidelines at the time of the study. Forty-two patients with ICH, within 8 h of onset, with elevated MAP (≥ 110 mmHg) were
randomized to standard treatment (target MAP 110-130 mmHg, n = 21) or aggressive treatment (target MAP < 110 mmHg). Baseline characteristics were
similar except that the ICH and edema volumes were larger in the aggressive BP group. IV labetalol, nicardipine, or sodium nitroprussid was used and target
BP was obtained within 87.1 ± 59.6 min in the standard treatment group and 163.5 ± 163.8 min in the aggressive BP treatment group. No significant differences

were found between two groups in terms of hematoma and edema growth, early neurological deterioration, and clinical outcome at 90 days.