Abstract Details

Title In-hospital Outcomes Among Patients with Severe vs Mild-moderate Hypertension Following Spontaneous Intracerebral Hemorrhage

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P9 - Poster Session 9 (5:00 PM-6:00 PM)

Poster/Presentation
Number 4-008

Objective To compare clinical characteristics, treatment responses, and outcomes in patients with spontaneous intracerebral hemorrhage (SICH) presenting with severe hypertension (sHTN; systolic blood pressure [SBP] >220 mmHg) versus mild to moderate hypertension (mmHTN; SBP 140–220 mmHg).

Background Patients with SICH and sHTN are underrepresented in major clinical trials due to restrictive eligibility criteria. Consequently, current BP management strategies are largely based on data from patients with mmHTN, and potential differences in presentation or outcomes between these groups remain poorly defined.

Design/Methods We retrospectively reviewed records of adults patients admitted with SICH to a tertiary center in the Southeastern US (January–December 2020; October 2024–June 2025). Patients were categorized as sHTN or mmHTN. Baseline characteristics, clinical features, and in-hospital outcomes were compared using Mann–Whitney U, chi-square, or Fisher’s exact tests. Logistic regression identified independent predictors of in-hospital mortality.

Results Among 147 patients (median age 63 years, 61% male), 15 (10%) had sHTN. Compared with mmHTN, sHTN patients tended to be younger, more often male, universally had a history of hypertension, and had higher rates of positive urine drug screen, although these differences were not statistically significant. Those with sHTN had significantly longer hospital stays (median 16 vs. 9 days; p=0.013). Hemorrhage volumes, locations, and neurological severity scores were similar between groups. In-hospital mortality did not differ significantly (sHTN, 17% vs. mmHTN, 28%, p=0.55). On multivariable analysis, larger ICH volume (OR 1.04; p=0.0046) and intraventricular hemorrhage, IVH (OR 4.91; p=0.0029) independently predicted mortality, but sHTN was not associated with mortality.

Conclusions Despite a longer hospital stay, patients with SICH and sHTN are not at an increased risk of mortality when compared to those with mmHTN. Admission ICH volume and IVH were significant predictors of mortality. Larger cohort studies are needed to clarify the prognostic impact of sHTN in SICH.

Authors/Disclosures
Parth Patel, MD (AUMC) PRESENTER	Dr. Patel has nothing to disclose.
Sam Natla, MD (Augusta University, Medical College of GA)	Dr. Natla has nothing to disclose.
Priyanka Menon, BA	Ms. Menon has nothing to disclose.
Anthony Elengickal	Mr. Elengickal has nothing to disclose.
Srijita Nandy, Medical Student	Miss Nandy has nothing to disclose.
Nicole V. Tayag, Medical Student	Miss Tayag has nothing to disclose.
Mashoor Al Ahammed	Mr. Ahammed has nothing to disclose.
Askiel Bruno, MD, FAAN (Medical College of Georgia, Augusta University)	The institution of Dr. Bruno has received research support from Georgia Rehabilitation Institute. The institution of Dr. Bruno has received research support from Janssen Pharma.
Manan Shah, MD, MBBS (Augusta University Medical Center, Dept Of Neurology)	Dr. Shah has nothing to disclose.
Ashutosh Pandey, MD	No disclosure on file
Klepper Alfredo Garcia, MD (Augusta University - Neurocritical Care Division)	Dr. Garcia has nothing to disclose.
Amir A. Mbonde, MD (Mayo Clinic Arizona)	Dr. Mbonde has nothing to disclose.

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