Pharmacological control of blood hypertension and hyperglycemia in acute phase of intracerebral haemorrhage

摘要

Blood hypertension and hyperglycemia are both risk factors for intracerebral haemorrhage (ICH) and negative prognostic factors of mortality and functional disability when occur in the acute phase of ICH. However, the intensive treatment of both these conditions has not clearly shown positive effects in reducing mortality and morbidity. Two recent clinical trials (INTERACT and ATACH) have shown that the aggressive lowering of systolic blood pressure (target 140 mmHg) may reduce the hematoma enlargement without increasing the risk of ischemic events due to lowering of the cerebral perfusion pressure, neurological deterioration, worsening of the life quality and disability. Intensive treatment of hyperglycemia has been associated to an increase of the risk of hypoglycemia with secondary increased risk of mortality. Blood pressure and glycemia should be monitored during the acute phase of ICH, but optimal strategies and targets still remain unclear.