36
Hypertension in Patients With Comorbidities
Acute Intracerebral Hemorrhage (ICH)
COR LOE
Recommendations
IIa C-EO In adults with ICH who present with SBP greater than 220 mm
Hg, it is reasonable to use continuous intravenous drug infusion
(Table 14) and close BP monitoring to lower SBP.
III:
Harm
A Immediate lowering of SBP (Table 14) to less than 140 mm Hg in
adults with spontaneous ICH who present within 6 hours of the
acute event and have an SBP between 150 mm Hg and 220 mm
Hg is NOT of benefit to reduce death or severe disability and can
be potentially harmful.
Figure 7. Management of Hypertension in Patients with
Acute ICH
Acute (<6 h from symptom onset
spontaneous ICH)
SBP
150–200 mm
Hg
SBP lowering with
continuous IV infusion
and close BP monitoring
(Class IIa)
SBP lowering to
<140 mm Hg
(Class III: Harm)
SBP
>220 mm Hg
Colors correspond to Class of Recommendation on page 56–57.
