Stroke Clinical Trial
Official title:
Antihypertensive Treatment in Acute Cerebral Hemorrhage (ATACH)
The purpose of this trial is to evaluate the safety and effectiveness of lowering blood pressure using nicardipine in persons with acute hypertension associated with intracerebral hemorrhage.
An estimated 37,000 to 52,400 people in the United States have intracerebral hemorrhage (ICH)
every year. ICH——a form of stroke that has poor outcome and is difficult to treat——is
associated with the highest mortality rate of all strokes. Hematoma expansion has been
identified as the most common cause of neurological deterioration in persons with ICH. Early
evidence suggests that acute hypertension (HTN)—or elevated blood pressure—may make some
individuals more susceptible to hematoma expansion. Treating HTN acutely may prevent hematoma
expansion, however, the effect of aggressive HTN treatment has not been determined.
The purpose of this trial is to evaluate the treatment feasibility and safety of lowering
blood pressure using nicardipine——an antihypertensive medication——in persons who have acute
HTN associated with ICH.
This pilot study will enroll 60 individuals who qualify with a presenting systolic blood
pressure of at least 170 mmHg, have an ICH, and can be evaluated and treatment initiated
within 6 hours of onset of stroke symptoms. In a stepwise fashion, the scientists will
investigate the potential consequences of controlling blood pressure with intravenous
nicardipine at 3 sequential levels: 170 to 200 mmHg, 140 to 170 mmHg, and 110 to 140 mmHg.
Twenty participants will be enrolled per level.
Treatment will last 18 to 24 hours. Participants will stay in the hospital for about 7 days
(including 24 hours in the intensive care unit for close monitoring) and will return for
1-hour follow-up visits at 30 days and at 90 days after discharge from the hospital. During
these visits participants will receive neurological assessments to determine their functional
outcome. For participants, the study will be completed after the 90-day follow-up visit.
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