Evidence map›Paper›PMID 40993486›Full record

Trial reportNeurocritical care2026

The Association between Hourly Systolic Blood Pressure Variability and Outcomes in Patients with Intracerebral Hemorrhage is Time-Dependent: Post-hoc Analysis of the ATACH-2 Trial.

Adnan I Qureshi, William Baskett, Joao A Gomes, Pashmeen Lakhani, Alejandro A Rabinstein, David Z Rose, Jose I Suarez, Thorsten Steiner, Chi-Ren Shyu

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Neurocritical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Adnan I QureshiZeenat Qureshi Stroke Institute, Columbia, MO, USA. qureshai@gmail.com.ORCID 0000-0003-4962-540X
William BaskettInstitute for Data Science and Informatics, University of Missouri, Columbia, MO, USA.
Joao A GomesCleveland Clinic Lerner College of Medicine, Cleveland, OH, USA.
Pashmeen LakhaniZeenat Qureshi Stroke Institute, Columbia, MO, USA.
Alejandro A RabinsteinMayo Clinic, Rochester, MN, USA.
David Z RoseUniversity of South Florida Morsani College of Medicine/Tampa General Hospital, Tampa, FL, USA.
Jose I SuarezDivision of Neurosciences Critical Care, The Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Thorsten SteinerVarisano Klinikum Frankfurt Höchst, Frankfurt, Germany.
Chi-Ren ShyuInstitute for Data Science and Informatics, University of Missouri, Columbia, MO, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSystolic blood pressure (SBP) variability has been associated with an increase in rates of death or disability in patients with intracerebral hemorrhage (ICH). We analyzed data from the Antihypertensive Treatment of Acute Cerebral Hemorrhage (ATACH)-2 trial to determine whether the association between SBP variability and death or disability at 90 days is dependent on the time from randomization.

methodsThe difference between maximum and minimum SBP (hourly SBP range) for the first 24 h after enrollment was used to calculate the hourly SBP variability. The effect of hourly SBP variability was evaluated in logistic regression models on: (1) death or disability (modified Rankin scale score of 4-6 at 90 days), (2) hematoma expansion (increase of > 33% in volume on the computed tomography scan obtained at 24 h) within 24 h, (3) neurological deterioration within 24 h, and (4) acute kidney injury within 72 h after enrollment. We adjusted for age, baseline Glasgow Coma Scale score, intraventricular hemorrhage, hematoma volume, and maximum SBP values for each time window.

resultsA total of 961 patients (mean age ± standard deviation [SD], 62 ± 13 years; 61.9% were men) who were enrolled at a mean ± SD time of 184 ± 56 min from symptom onset were analyzed. The mean ± SD hourly SBP variability was 15.6 ± 16 mm Hg. The hourly SBP variability became significantly lower with increasing time intervals from randomization (ranging from 41.8 ± 23.3 at hour 1 to 12.4 ± 14.0 at hour 24, P < 0.0001). SBP variability at five hours (P = 0.014) and six hours (P = 0.014) after enrollment was significantly associated with death or disability at 90 days, with positive but not statistically significant associations observed at all other points up to eight hours after randomization. Risk of neurological deterioration within 24 h was highly associated with SBP variability, with the largest association observed between one (P < 0.001) and five (P < 0.001) hours following randomization, with significant associations observed up to 22 h following randomization. Risk of hematoma expansion was associated with SBP variability between three (P = 0.015) and eight (P = 0.002) hours after randomization. Statistically significant associations between SPB variability and risk of acute kidney injury were not observed.

conclusionsReduced SBP variability within the first eight hours following randomization appears most impactful on both short-term and long-term outcomes in patients with ICH, and the first eight hours may represent a time window for future interventions directed at reducing SBP variability in patients with ICH.

Indexed as

Antihypertensive AgentsBlood PressureCerebral HemorrhageOutcome Assessment, Health CareAgedFemaleHematomaHumansMaleMiddle AgedTime FactorsAntihypertensive AgentsDeath or disabilityIntracerebral hemorrhageNeurological deteriorationSystolic blood pressureTime-dependent

Identifiers

PMID40993486

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.