Intensive BP Lowering Reduces Recurrent Stroke After Intracerebral Hemorrhage

THURSDAY, Sept. 3, 2026 (HealthDay News) — Intensive blood pressure-lowering treatment after intracerebral hemorrhage reduces the risk for recurrent stroke without an increase in serious adverse events, according to a study published in the September issue of The Lancet Neurology.

Xia Wang, Ph.D., from the University of New South Wales in Australia, and colleagues pooled individual-level data to quantify the size, heterogeneity, and timing of the effects of blood pressure-lowering treatment for the secondary prevention of major cardiovascular end points in patients with a history of intracerebral hemorrhage. Trials were included if participants were randomly assigned to fixed-dose antihypertensive therapy or an intensive, titrated target-based blood pressure-lowering strategy versus placebo or standard blood pressure management (control groups). Participant data for the analysis were provided by four eligible trials; the meta-analysis included 2,944 participants.

The researchers found that the mean difference in systolic blood pressure between blood pressure-lowering treatment and control was 11.2 mm Hg during follow-up. The hazard of first recurrent stroke of any type was reduced with intensive blood pressure-lowering versus control (6.5 versus 10.4 percent of participants; adjusted hazard ratio, 0.62). This finding was driven by fewer recurrent intracerebral hemorrhage events (2.2 versus 5.6 percent; adjusted hazard ratio, 0.39). Serious adverse events occurred in 28.9 and 33.0 percent of patients in the intensive and control groups, respectively. The treatment effects were consistent across prespecified subgroups. An estimated 6.1 months was necessary to achieve a 1 percent absolute benefit.

“Our analysis shows that intensive blood pressure treatment can prevent 16 recurrent strokes for every 1,000 patients treated within the first year alone. These findings reinforce the central role of blood pressure control in secondary stroke prevention,” coauthor Craig S. Anderson, M.B.B.S., from the University of New South Wales, said in a statement.

One author disclosed ties to the biopharmaceutical industry.

Abstract/Full Text (subscription or payment may be required)