University of Leicester (UK) researchers have contributed to a landmark
study which has revealed a new way to treat strokes caused by bleeding
inside the brain.
The study found that intensive blood pressure lowering in patients
with intracerebral haemorrhage, the most serious type of stroke, reduced
the risk of major disability and improved chances of recovery by as
much as 20 per cent.
The study, which involved more than 2800 patients from 140 hospitals
around the world, was announced at the European Stroke Conference
in London, and published in The New England Journal of Medicine.
Professor Thompson Robinson, Deputy Head of the University of
Leicester’s Department of Cardiovascular Sciences, was the UK
co-ordinator for the study and co-authored the paper.
The study was led by the George Institute for Global Health, in Sydney, Australia.
Professor Thompson Robinson said: “Stroke is the third most common
cause of death in the UK and the most common adult cause of neurological
disability. Approximately 1 million people are living with the
consequences of stroke in the United Kingdom, a third with life-changing
severe disability. Every year an estimated 152,000 people in the UK
have a stroke and intracerebral haemorrhage - spontaneous bleeding
within the brain most often due to hypertension - accounts for at least
10 per cent of all cases.
“Intracerebral haemorrhage kills about half of those affected within
one month and leaves most survivors disabled, and to date there is no
specific treatment for this type of stroke.
“The results of the study show that intensively reducing high blood
pressure within 6 hours of onset of a bleeding-related stroke is safe,
and results in a significant shift from being dead and dependent to
being alive and independent after stroke. Because it involves treatment
with already available blood pressure-lowering treatments, the results
should be easy to implement in all hospitals and be of benefit to
patients. It is important to reinforce that stroke is a medical
emergency, and individuals who suspect that they may have had a stroke
should dial 999 (UK) and seek urgent medical attention.
“Leicester has a long-standing interest in acute stroke and blood
pressure research, and hosts the NIHR Trent Stroke Local Research
Network. There are many opportunities for Leicester patients presenting
with stroke to participate in research to improve outcomes for future
patients with stroke.”
Professor Bruce Neal of The George Institute and The University of
Sydney said the study challenges previous thought about blood pressure
lowering in intracerebral haemorrhage.
He said: “The study findings will mean significant changes to guidelines for stroke management worldwide. They show that early intensive blood pressure lowering, using widely available therapies, can significantly improve the outcome of this illness.
“We hope to see hospital emergency departments around the world
implement the new treatment as soon as possible. By lowering blood
pressure, we can slow bleeding in the brain, reduce damage and enhance
“The study findings are tremendously exciting because they provide a
safe and efficient treatment to improve the likelihood of a recovery
without serious disability - a major concern for those who have
“The only treatment option to date has been risky brain surgery, so this research is a very welcome advance.”
The study found patients who suffered an acute intracerebral
haemorrhage and received the blood pressure lowering treatment were
better off from both a physical and psychological perspective.
- Full bibliographic informationThe New England Journal of Medicine - "Rapid Blood-Pressure Lowering in Patients with Acute Intracerebral Hemorrhage" - Craig
S. Anderson, M.D., Ph.D., Emma Heeley, Ph.D., Yining Huang, M.D.,
Jiguang Wang, M.D., Christian Stapf, M.D., Candice Delcourt, M.D.,
Richard Lindley, M.D., Thompson Robinson, M.D., Pablo Lavados, M.D.,
M.P.H., Bruce Neal, M.D., Ph.D., Jun Hata, M.D., Ph.D., Hisatomi Arima,
M.D., Ph.D., Mark Parsons, M.D., Ph.D., Yuechun Li, M.D., Jinchao Wang,
M.D., Stephane Heritier, Ph.D., Qiang Li, B.Sc., Mark Woodward, Ph.D.,
R. John Simes, M.D., Ph.D., Stephen M. Davis, M.D., and John Chalmers,
M.D., Ph.D. for the INTERACT2 Investigators
May 29, 2013DOI: 10.1056/NEJMoa1214609