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Conference Paper: Benefit and risk of lower follow-up blood pressure after intracerebral haemorrhage

TitleBenefit and risk of lower follow-up blood pressure after intracerebral haemorrhage
Authors
Issue Date2021
PublisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org/
Citation
26th Medical Research Conference, Department of Medicine, The University of Hong Kong, Virtual Conference, Hong Kong, 16 January 2021. In Hong Kong Medical Journal, 2021, v. 27 n. 1, Suppl. 1, p. 47, abstract no. 80 How to Cite?
AbstractIntroduction: Intracerebral haemorrhage (ICH) survivors are prone to recurrent ICH, and blood pressure (BP) control is the sole modifiable risk for ICH recurrence. It remained unclear whether a more intensive BP target during follow-up would be beneficial, with the concern of increased mortality. Hence, we aimed to study the benefit and risks of lower follow-up BP in ICH survivors Methods: We studied the follow-up data of 501 primary ICH survivors from the prospective stroke registry of The University of Hong Kong, who were admitted from January 2011 to March 2019. Follow-up data were retrieved from the electronic patient record system or written medical notes. Our primary end-points were recurrent ICH, cardiovascular mortality, and all-cause mortality. The adjusted hazard ratios (HR) for each BP categories during follow-up were derived using multivariate Cox regression. Results: During a median FU of 4.2 years (interquartile range=2.2-6.1), there were 39 recurrent ICHs. When compared with systolic BP (SBP) of <120 mmHg, higher SBP categories were associated with an increasing risk of recurrent ICH (HR=4.5 for SBP 120-139 mmHg, 95% confidence interval [CI]=1.1-19.1; HR=10.4 for SBP 140-159 mmHg, 95% CI=2.1-50.8; HR=46.6 for SBP ≥160 mmHg, 95% CI=7.7-283.1). Similarly, the recurrent ICH risk increased with higher diastolic BP (DBP) categories. There was a J-shape relationship between SBP and all-cause mortality (HR=1.7 for SBP <120 mmHg, 95% CI=1.1-2.6; HR=2.0 for SBP 140-159 mmHg, 95% CI=1.1-3.3; HR=4.3 for SBP ≥160 mmHg, 95% CI=1.6-12.0), but not for cardiovascular mortality. No J-shape relationship was observed between DBP and all-cause mortality. In the subgroup analysis of patients aged ≤70 years, lower BP did not heighten all-cause mortality risk. Conclusion: A more intensive BP target of below 120/70 should be considered in ICH survivors, especially in patients aged ≤70 years.
Descriptione-Poster Presentation: Clinical Research Session - abstract no. 80
Persistent Identifierhttp://hdl.handle.net/10722/295808
ISSN
2023 Impact Factor: 3.1
2023 SCImago Journal Rankings: 0.261

 

DC FieldValueLanguage
dc.contributor.authorTeo, KC-
dc.contributor.authorLeung, CYW-
dc.contributor.authorYeung, C-
dc.contributor.authorWong, YK-
dc.contributor.authorChan, KH-
dc.contributor.authorCheung, RTF-
dc.contributor.authorHo, SL-
dc.contributor.authorLau, GKK-
dc.date.accessioned2021-02-08T08:14:19Z-
dc.date.available2021-02-08T08:14:19Z-
dc.date.issued2021-
dc.identifier.citation26th Medical Research Conference, Department of Medicine, The University of Hong Kong, Virtual Conference, Hong Kong, 16 January 2021. In Hong Kong Medical Journal, 2021, v. 27 n. 1, Suppl. 1, p. 47, abstract no. 80-
dc.identifier.issn1024-2708-
dc.identifier.urihttp://hdl.handle.net/10722/295808-
dc.descriptione-Poster Presentation: Clinical Research Session - abstract no. 80-
dc.description.abstractIntroduction: Intracerebral haemorrhage (ICH) survivors are prone to recurrent ICH, and blood pressure (BP) control is the sole modifiable risk for ICH recurrence. It remained unclear whether a more intensive BP target during follow-up would be beneficial, with the concern of increased mortality. Hence, we aimed to study the benefit and risks of lower follow-up BP in ICH survivors Methods: We studied the follow-up data of 501 primary ICH survivors from the prospective stroke registry of The University of Hong Kong, who were admitted from January 2011 to March 2019. Follow-up data were retrieved from the electronic patient record system or written medical notes. Our primary end-points were recurrent ICH, cardiovascular mortality, and all-cause mortality. The adjusted hazard ratios (HR) for each BP categories during follow-up were derived using multivariate Cox regression. Results: During a median FU of 4.2 years (interquartile range=2.2-6.1), there were 39 recurrent ICHs. When compared with systolic BP (SBP) of <120 mmHg, higher SBP categories were associated with an increasing risk of recurrent ICH (HR=4.5 for SBP 120-139 mmHg, 95% confidence interval [CI]=1.1-19.1; HR=10.4 for SBP 140-159 mmHg, 95% CI=2.1-50.8; HR=46.6 for SBP ≥160 mmHg, 95% CI=7.7-283.1). Similarly, the recurrent ICH risk increased with higher diastolic BP (DBP) categories. There was a J-shape relationship between SBP and all-cause mortality (HR=1.7 for SBP <120 mmHg, 95% CI=1.1-2.6; HR=2.0 for SBP 140-159 mmHg, 95% CI=1.1-3.3; HR=4.3 for SBP ≥160 mmHg, 95% CI=1.6-12.0), but not for cardiovascular mortality. No J-shape relationship was observed between DBP and all-cause mortality. In the subgroup analysis of patients aged ≤70 years, lower BP did not heighten all-cause mortality risk. Conclusion: A more intensive BP target of below 120/70 should be considered in ICH survivors, especially in patients aged ≤70 years.-
dc.languageeng-
dc.publisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org/-
dc.relation.ispartofHong Kong Medical Journal-
dc.relation.ispartof26th Medical Research Conference-
dc.rightsHong Kong Medical Journal. Copyright © Hong Kong Academy of Medicine Press.-
dc.titleBenefit and risk of lower follow-up blood pressure after intracerebral haemorrhage-
dc.typeConference_Paper-
dc.identifier.emailTeo, KC: tkc299@hku.hk-
dc.identifier.emailChan, KH: koonho@hku.hk-
dc.identifier.emailCheung, RTF: rtcheung@hkucc.hku.hk-
dc.identifier.emailHo, SL: slho@hku.hk-
dc.identifier.emailLau, GKK: gkklau@hku.hk-
dc.identifier.authorityChan, KH=rp00537-
dc.identifier.authorityCheung, RTF=rp00434-
dc.identifier.authorityHo, SL=rp00240-
dc.identifier.authorityLau, GKK=rp01499-
dc.description.natureabstract-
dc.identifier.hkuros321128-
dc.identifier.volume27-
dc.identifier.issue1, Suppl. 1-
dc.identifier.spage47, abstract no. 80-
dc.identifier.epage47, abstract no. 80-
dc.publisher.placeHong Kong-
dc.identifier.issnl1024-2708-

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