Abstract Number: Esoc2026a2108 Stroke Unit Assesment of Blood Pressure in Spontaneous Intracerebral Hemorrhage: Stable Study

Abstract Background and aims Early initiation of blood pressure (BP)-lowering treatment and BP control are associated with improved functional outcomes in intracerebral hemorrhage (ICH). Our aim was to analyze BP management strategies and identify factors that might influence its control. Methods Prospective observational study of patients with spontaneous ICH (sICH) evaluating time metrics and rate of BP control at hospital admission. From July 2025 to December 2025 consecutive patients were included after informed consent. Participants were managed according to current guidelines and BP was recorded every five minutes. The selection and dosage of antihypertensive agents were documented. Results Of the 50 consecutive sICH patients planned, data from 23 patients has been included to date; 91.3% were supratentorial and 85.7% were deep sICH. Hematoma volume was 12.46mLIQR 5-20.55 and median NIHSS was 8IQR 7-15. Median systolic and diastolic BP on admission was 185 mmHgIQR 155-210 and 99 mmHgIQR 90-100. Continuous intravenous infusion was needed in 87.0%. As first-line infusion therapy, 69.6% received urapidil and 17.4% clevidipine, with 30.4% of patients on urapidil requiring a second infusion drug vs 0% with clevidipine (p=0.2). BP control (140/90mmHg) within the first hour was achieved in 30.4%. Hematoma expansion (HE) was detected within 24 hours in 31.5%. There was a trend towards an increased risk of HE with delayed BP control OR 6; 95%CI(0.7–51.1);p=0.10 in binary logistic regression. Conclusions Given the uncertainties regarding BP-lowering strategies in sICH, rapid lowering of BP and choice of antihypertensive agents could have an impact on clinical outcomes Conflict of interest Diego Villagrán Sancho: nothign to disclose