| dc.description.abstract | New recommendations for the management of spontaneous intracerebral haemorrhage (ICH), introduced in 2014, presents a change in approach to acute antihypertensive treatment, with emphasis on early, intensive blood pressure reduction. (1, 2) This is based on growing evidence suggesting rapid blood pressure lowering is safe, and may have favourable effect on functional outcome. The purpose of this study is to investigate if new recommendations have led to change in the way high blood pressure in patients with spontaneous intracerebral haemorrhage is treated at Akershus University Hospital. Methods: A total of 100 patients were assigned into two groups based on the date they were diagnosed with and treated for ICH – 50 patients in 2013 before the new recommendations were introduced, and 50 patients in 2015, after the new recommendations were introduced. Their medical journals were analysed based on predefined variables designed to collect information on development of systolic blood pressure values and antihypertensive treatment. A chi-square test was conducted to test if the blood pressure development and management were independent of when the patients received treatment. Results: Among patients with ICH and systolic blood pressure > 140 mmHg, chi-square test revealed a significant difference between the two groups in the number of patients receiving antihypertensive treatment (22/50 in 2013 against 34/50 in 2015, p = 0,016), and also in the number of patients treated with Labetolol (Trandate ®) (8/50 in 2013 against 28/50 in 2015, p = 0,00003), which is the current recommended medication. Very few patients in the 2015 group had systolic blood pressure below 140 within one (4/34) and two hours (4/34) after initiating antihypertensive treatment, and few maintained a systolic blood pressure below 140 for 24 hours, after initial reduction with Labetolol (Trandate ®) (2/28). These variables could not be evaluated with chi-square test because the number of patients in the relevant categories were too low. Conclusion: Results from this study indicate that new recommendations have led to increased use of acute antihypertensive medication in order to reduce blood pressure among patients with ICH and systolic blood pressure > 140 mmHg. However, the number of patients meeting the recommended goals for blood pressure after hospitalization, is low, indicating possible insufficient treatment. References 1. NevroNEL. Høyt blodtrykk - Akuttbehandling ved hjerneinfarkt og blødning 2016 [updated 7.11.2016; cited 27.01. 2017]. Available from: http://nevro.legehandboka.no/imagevault/publishedmedia/sqbnzmmdezeapk7j65i5/26394-2-bt-ved-hjerneslag.pdf. 2. NevroNEL. Hjerneblødning (spontan intracerebral blødning) 2016 [updated 07.11.2016; cited 16.01. 2017]. Available from: http://nevro.legehandboka.no/handboken/sykdommer/cerebrovaskulare-sykdommer/sykdommer-og-symptomer/hjerneblodning/. | eng |