Abstract Number: Esoc2026a752 Influence of Time to Achieve Target Systolic Blood Pressure on Outcomes in Patients With Intracerebral Hemorrhage: A Secondary Analysis of the Interact4 Trial

Abstract Background and aims Evidence regarding the association between the time to achieve and maintain systolic blood pressure within the target range and outcomes in patients with intracerebral hemorrhage remains limited. This study evaluated this association using blood pressure data from both prehospital and in-hospital phases, with a target range of 130-140 mmHg. Methods We utilized individual patient data from the INTERACT4 trial. Time was defined as the interval from symptom onset to first achievement of target systolic blood pressure (130–140 mmHg), provided that the target was subsequently maintained until 24 hours after hospital admission. The primary outcome was mortality or dependency at 90 days, defined as a modified Rankin Scale score of 3-6. Logistic regression models were employed with adjustment for covariates. Results A total of 982 patients were included in the analysis. Longer time to achieve target systolic blood pressure was significantly associated with a higher risk of 90-day mortality or dependency (OR 1.18, 95% CI 1.02–1.37, P=0.025). In subgroup analyses, this association was statistically significant in patients with deep hematoma locations (thalamus/basal ganglia, internal capsule) (OR 1.22, 95% CI 1.04–1.45, P=0.018). Among patients with documented target attainment, achieving target blood pressure during the prehospital ambulance phase was associated with better outcomes compared with in-hospital attainment within 24 hours after admission (OR 0.62, 95% CI 0.41–0.96, P=0.029). Conclusions Our study confirms a clear time relation between earlier versus later achievement and maintenance of target systolic blood pressure, starting from the prehospital phase, and outcomes in patients with intracerebral hemorrhage. Conflict of interest Yuetong Luo: nothing to disclose. Yapeng Lin: nothing to disclose. Guoliang Zhu: nothing to disclose. Yujie Tang: nothing to disclose. Ruijuan Gang: nothing to disclose. Rong Wang: nothing to disclose. Qi Wang: nothing to disclose. Jie Yang: nothing to disclose.