Lowering blood pressure reduces brain bleeding in strokes

The search for treatments for spontaneous intracerebral hemorrhage, the most devastating type of stroke, which carries a 40% mortality rate, has been rife with disappointments. But a new study suggests that intensive blood pressure lowering may reduce the amount of bleeding in deep areas of the brain in patients with the condition, a team of Yale researchers report May 13 in the journal JAMA Neurology.

Although blood pressure reduction was associated with less ongoing bleeding, the analysis did not find an improvement in clinical outcomes. "This analysis demonstrates biological proof-of-concept of intensive blood pressure reduction as a therapy for intracerebral hemorrhage," said Audrey Leasure, a second-year medical student at the Yale School of Medicine and lead author of the study. She said that larger studies of the subset of patients with damage to those areas of the brain may show improved therapeutic outcomes from intensive blood pressure reduction and that the specific location of brain injury should be incorporated into the design of future trials of brain hemorrhage.

Yale neurologists Guido Falcone and Kevin Sheth are co-corresponding authors on the paper.