1. ¹Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, Malaysia
2. ²Advanced Medical and Dental Institute, Universiti Sains Malaysia, Malaysia
3. ³Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Malaysia
4. ⁴Preventive Cardiology Medical Hospital and Research Centre, Moradabad, India

Correspondence: Dr AHG Rasool, Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan 16150, Malaysia. E-mail: aida@kb.usm.my

Received 10 December 2002; Revised 7 July 2003; Accepted 25 August 2003.

Abstract

Stroke is one of the leading causes of death worldwide, and spontaneous bleeding into the brain parenchyma, intracerebral haemorrhage (ICH), is a stroke subtype associated with high morbidity and mortality. Overall, it comprises about 15% of all stroke in Caucasians, this figure being much higher in Asians and black people. Blood pressure (BP) appears to play an important role in this disease. We have reviewed available literature on the relationship of BP to the occurrence of primary and secondary ICH, the association of BP levels measured early after stroke with prognosis and complications, and evidence about the effects of early BP lowering treatments on post-stroke outcomes. BP appears to be an important risk factor for primary and secondary ICH. In addition, high BP early after ICH may be detrimental to outcome, possibly contributing to complications such as rebleeding and haematoma enlargement. Few data are available about the effects of early lowering of BP on outcome after ICH with no reliable trial yet conducted. Proper randomised trials are required to establish the effect of early lowering of BP on outcome after ICH.