The authors performed a multicenter prospective study to evaluate the feasibility and safety of intravenous nicardipine hydrochloride for acute hypertension in patients with intracerebral hemorrhage (ICH). This study included 88 patients (mean age: 58.3 yr, range 26-87 yr) with ICH and acute hypertension in 5 medical centers between August 2008 and November 2010, who were treated using intravenous nicardipine. Administration of nicardipine resulted in a decrease from mean systolic blood pressure (BP) (175.4 +/- 33.7 mmHg) and diastolic BP (100.8 +/- 22 mmHg) at admission to mean systolic BP (127.4 +/- 16.7 mmHg) and diastolic BP (67.2 +/- 12.9 mmHg) in 6 hr after infusion (P < 0.001, mixed-effect linear models). Among patients who underwent follow-up by computed tomography, hematoma expansion at 24 hr (more than 33% increase in hematoma size at 24 hr) was observed in 3 (3.4%) of 88 patients. Neurological deterioration (defined as a decrease in initial Glasgow coma scale > or = 2) was observed in 2 (2.2%) of 88 patients during the treatment. Aggressive nicardipine treatment of acute hypertension in patients with ICH can be safe and effective with a low rate of neurological deterioration and hematoma expansion.
Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Antihypertensive Agents/adverse effects/*therapeutic use ; Blood Pressure ; Cerebral Hemorrhage/*drug therapy ; Cohort Studies ; Female ; Follow-Up Studies ; Glasgow Coma Scale ; Hematoma/etiology ; Humans ; Injections, Intravenous ; Male ; Middle Aged ; Nicardipine/adverse effects/*therapeutic use ; Prospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome