Association Between Preonset Anti-hypertensive Treatment and Intracerebral Hemorrhage Mortality: A Cohort Study From CHEERY

Yan Wan; Hongxiu Guo; Jing Shen; Shaoli Chen; Man Li; Yuanpeng Xia; Lei Zhang; Zhou Sun; Xiaolu Chen; Jiang Chang; David Wang; Quanwei He; Bo Hu

doi:10.3389/fneur.2022.794080

Association Between Preonset Anti-hypertensive Treatment and Intracerebral Hemorrhage Mortality: A Cohort Study From CHEERY

Front Neurol. 2022 Mar 7:13:794080. doi: 10.3389/fneur.2022.794080. eCollection 2022.

Authors

Yan Wan¹, Hongxiu Guo¹, Jing Shen¹, Shaoli Chen¹, Man Li¹, Yuanpeng Xia¹, Lei Zhang¹, Zhou Sun¹, Xiaolu Chen¹, Jiang Chang², David Wang³, Quanwei He¹, Bo Hu¹

Affiliations

¹ Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
² Department of Epidemiology and Biostatistics, Key Laboratory for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
³ Neurovascular Division, Department of Neurology, Barrow Neurological Institute/Saint Joseph Hospital Medical Center, Phoenix, AZ, United States.

Abstract

Introduction: Hypertension is the most prevalent risk factor for intracerebral hemorrhage (ICH). In this study, we investigated whether preonset anti-hypertensive therapy could affect the outcomes of ICH.

Methods: This was a retrospective cohort study. A total of 3,460 consecutive patients with acute first-ever ICH from 31 recruitment sites were enrolled into the Chinese cerebral hemorrhage: mechanism and intervention (CHERRY) study from December 1, 2018 to November 30, 2020, and 2,140 (61.8%) with hypertension history were entered into the analysis.

Results: Only 586 patients (27.4%) with hypertension history currently received anti-hypertensive therapy, and which was associated with lower systolic blood pressure (SBP) and diastolic blood pressure (DBP) on admission (SBP, p = 0.008; DBP, p = 0.017), less hematoma volume (9.8 vs. 11%, p = 0.006), and lower all-cause mortality at 3 months (15.3 vs. 19.8%, OR = 0.728, p = 0.016). In multivariable analysis, adjusting for age, gender, residence, ischemic stroke history, admission SBP and DBP, and current use of antihypertension were significantly associated with lower adjusted hazard ratios (HRs) for all-cause mortality at discharge (adjusted HR, 0.497, p = 0.012), 30 days (adjusted HR, 0.712, p = 0.015), and 90 days (adjusted HR, 0.766, p = 0.030). However, after adjusting the variable of hematoma volume, the mortality between the two groups was not significantly different.

Conclusions: Preonset anti-hypertensive therapy was associated with lower mortality of ICH, which somewhat depended on hematoma volume.

Keywords: CHEERY study; hematoma volume; hypertension; intracerebral hemorrhage; mortality.