Abstract DP034: Rapid Blood Pressure Reduction In Patients with Intracerebral Hemorrhage And Chronic Hypertension: A Secondary Analysis of the ATACH-2 Trial

Background: Intensive blood pressure (BP) reduction is recommended after intracerebral hemorrhage (ICH); however, treatment effects were modest across trials. Untreated chronic hypertension (HTN) impairs cerebral autoregulation, and cerebral hypoperfusion may limit the benefit of intensive BP reduction in the setting of impaired autoregulation. We hypothesized that untreated HTN treatment reduced the benefit of BP reduction on early neurologic decline (END). Methods: This secondary analysis of the Antihypertensive Treatment of Acute Cerebral Hemorrhage-2 trial included patients with a history of HTN and BP medication adherence within 30 days prior to ICH. Patients were randomized to a standard (