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The Effect of Intensive Blood Pressure Reduction on Perihematomal Edema After Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis.

Created on 15 Sep 2026

Authors

Xianxian Li, Chengguang Zou, Yuchao Jia, Chensheng Pan, Xiaodong Ye, Suiqiang Zhu, Shanshan Huang

Published in

Brain and behavior. Volume 16. Issue 9. Pages e71724.

Abstract

Perihematomal edema (PHE) is a radiological marker of intracerebral hemorrhage (ICH)-induced secondary brain injury. Whether intensive blood pressure (BP) reduction attenuates PHE expansion remains uncertain. We conducted a systematic review and meta-analysis to assess the effect of intensive BP reduction on approximately 24-h PHE expansion in patients with spontaneous ICH.
MEDLINE, Embase, and the Cochrane Library were searched from database inception to January 2026. Eligible studies compared intensive versus standard BP reduction in patients with spontaneous ICH and reported PHE-related outcomes. Risk of bias was assessed using the Cochrane risk-of-bias tool. Pooled estimates were calculated using the inverse-variance method with a fixed-effect model.
Six studies were included in the qualitative synthesis, and 4 studies were included in the quantitative meta-analysis, comprising 1061 patients in the intensive BP reduction group and 966 patients in the standard BP management group. Intensive BP reduction was associated with smaller approximately 24-h PHE expansion than standard BP management (mean difference, -0.50 mL; 95% CI, -0.89 to -0.12; p = 0.010). No statistical heterogeneity was observed (I2 = 0%).
Intensive BP reduction was associated with smaller approximately 24-h PHE expansion in patients with spontaneous ICH. Further standardized studies are needed to confirm the clinical relevance of this effect.

PMID:
42740560
Bibliographic data and abstract were imported from PubMed on 15 Sep 2026.

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