Influence of hypertension classification on hypertensive intracerebral hemorrhage location

Abstract

The authors sought to explore whether hypertension classification was risk factor for lobar and non-lobar hypertensive intracerebral hemorrhage (HICH) and the prognosis in patients with hematoma. This retrospective cohort study was conducted on HICH patients admitted at the First Affiliated Hospital of Soochow University. Observations with first-ever intracerebral hemorrhage (ICH) were recruited. The authors divided the brain image into three groups according to the location of ICH to predict whether there were significant differences between lobar and non-lobar ICH. A Mann-Whitney U test was used and this retrospective trial also compared the operation and mortality rates. Our cohort included 209 patients (73.7% male; median age:60.5±16.7). The overall incidence of lobar HICH was less than non-lobar HICH (24.4% vs. 68.4%), 7.2% cases of mixed HICH was included in this analysis. In a Mann-Whitney U test analyze, it indicated that there were significant differences in hypertension classification between lobar and non-lobar HICH (Z = -3.3, p<.05). And the percentage of hematoma in lobar areas with relatively slightly high blood pressure (BP) (high normal and grade 1 hypertension) accounts for 52.9% versus 30.1% in non-lobar areas. The increasing trends of the prevalent rate of lobar ICH with BP rising were not remarkable. The non-lobar HICH showed a sharper increase in the condition of grade 3 hypertension compared with lobar HICH. During the period of research, the fatality of lobar hemorrhage was 2.9% versus 7.7% (non-lobar). Besides, the fatality incidence of HICH with relatively slightly high BP (high normal and grade 1 hypertension) was lower than poorly controlled hypertensive patients (grade 2 and grade 3 hypertension). (8.0% vs. 15.7%). The increase of hypertension classification will aggravate the occurrence of non-lobar ICH and positively corrected with BP, but not in lobar areas. It is essential to understand the distinction influence of hypertension classification between lobar and non-lobar ICH.

Keywords: hypertension classification; lobar; non-lobar; prognosis.

FIGURE 1

Left pie diagram represented a scale model of lobar HICH and the right represented non‐lobar HICH. Both high normal and grade 1 hypertension showed an increase percentage in lobar areas than non‐lobar (52.9% vs. 30.1%). And the non‐lobar HICH showed an increase with the blood pressure level increasing