"This is the first time that we have randomized evidence of blood pressure control prior to reperfusion in ischemic stroke patients, and our data will challenge the current guidelines that recommend lowering blood pressure to below 180 mm Hg systolic in these patients," study co-author Craig Anderson, MD, George Institute for Global Health, Sydney, Australia, told"And this study also clearly shows for the first time that getting blood pressure under control in hemorrhagic stroke...
The median time between symptom onset and randomization was 61 minutes, and the mean blood pressure at randomization was 178/98 mm Hg. Overall, there was no difference between the two groups in terms of functional outcome scores , and the incidence of serious adverse events was similar. "We have never seen such a slam-dunk effect as there was in INTERACT4," Anderson said."Not only did we show that early reduction of blood pressure in hemorrhagic stroke patients improved functional outcome, it also reduced bleeding in the brain, improved survival and quality of life, and reduced surgery and infection complications. That's quite remarkable."
"This is the first trial in which blood pressure has been controlled in the ambulance and occurred much earlier than in the previous trials." The INTERACT4 results in ischemic stroke patients are likely to be more controversial. Commenting on the INTERACT4 results at the ESOC meeting, Simona Sacco, MD, professor of neurology at the University of L'Aquila, Italy, said this was a very important trial that would impact clinical practice.