Intensive or standard: a meta-analysis of blood pressure lowering for cerebral haemorrhage

The ideal target blood pressure(BP) has remaining controversial for patients with cerebral haemorrhage, so we performed a meta-analysis to assess the effects of intensive BP lowering therapy. Clinical trials in which acute-phase patients were randomly assigned to an intensive BP lowering group or a standard BP lowering group were included. The primary outcome was mortality and dependency at 90 days. The secondary outcomes were mortality at 90 days, the proportion of cases involving haematoma extension during the acute phase and early neurological deterioration. Although intensive BP lowering was associated with reduced mortality and dependency at 90 days, this result was not statistically significant (OR 0.89, 95% CI 0.77-1.02, P=0.09). No differences between the two groups were found with respect to the secondary outcomes. Significant differences remained absent in sensitivity analyses. The results suggested that intensive BP lowering does not affect 90-day outcomes, but appears to be safe.