Lowering blood pressure after acute intracerebral haemorrhage: protocol for a systematic review and meta-analysis using individual patient data from randomised controlled trials participating in the Blood Pressure in Acute Stroke Collaboration (BASC)

Introduction Conflicting results from multiple randomised trials indicate that the methods and effects of blood pressure (BP) reduction after acute intracerebral haemorrhage (ICH) are complex. The Blood pressure in Acute Stroke Collaboration is an international collaboration, which aims to determine...

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Main Authors: Keith W Muir, Gary Ford, Philip M Bath, Adnan I Qureshi, Thompson G Robinson, Rustam Al-Shahi Salman, Hisatomi Arima, Lisa J Woodhouse, Eivind Berge, Nikola Sprigg, Xia Wang, Tom J Moullaali, Zhe Kang Law, Candice Delcourt, Kailash Krishnan, Else C Sandset, Craig S Anderson, Yuko Palesch, John Potter, Jeff Saver, Nerses Sanossian, Ken Butcher, Kennedy R Lees, Janneke Horn
Format: Article
Language:English
Published: BMJ Publishing Group 2019-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/7/e030121.full
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author Keith W Muir
Gary Ford
Philip M Bath
Adnan I Qureshi
Thompson G Robinson
Rustam Al-Shahi Salman
Hisatomi Arima
Lisa J Woodhouse
Eivind Berge
Nikola Sprigg
Xia Wang
Tom J Moullaali
Zhe Kang Law
Candice Delcourt
Kailash Krishnan
Else C Sandset
Craig S Anderson
Yuko Palesch
John Potter
Jeff Saver
Nerses Sanossian
Ken Butcher
Kennedy R Lees
Janneke Horn
author_facet Keith W Muir
Gary Ford
Philip M Bath
Adnan I Qureshi
Thompson G Robinson
Rustam Al-Shahi Salman
Hisatomi Arima
Lisa J Woodhouse
Eivind Berge
Nikola Sprigg
Xia Wang
Tom J Moullaali
Zhe Kang Law
Candice Delcourt
Kailash Krishnan
Else C Sandset
Craig S Anderson
Yuko Palesch
John Potter
Jeff Saver
Nerses Sanossian
Ken Butcher
Kennedy R Lees
Janneke Horn
author_sort Keith W Muir
collection DOAJ
description Introduction Conflicting results from multiple randomised trials indicate that the methods and effects of blood pressure (BP) reduction after acute intracerebral haemorrhage (ICH) are complex. The Blood pressure in Acute Stroke Collaboration is an international collaboration, which aims to determine the optimal management of BP after acute stroke including ICH.Methods and analysis A systematic review will be undertaken according to the Preferred Reporting Items for Systematic review and Meta-Analysis of Individual Participant Data (IPD) guideline. A search of Cochrane Central Register of Controlled Trials, EMBASE and MEDLINE from inception will be conducted to identify randomised controlled trials of BP management in adults with acute spontaneous (non-traumatic) ICH enrolled within the first 7 days of symptom onset. Authors of studies that meet the inclusion criteria will be invited to share their IPD. The primary outcome will be functional outcome according to the modified Rankin Scale. Safety outcomes will be early neurological deterioration, symptomatic hypotension and serious adverse events. Secondary outcomes will include death and neuroradiological and haemodynamic variables. Meta-analyses of pooled IPD using the intention-to-treat dataset of included trials, including subgroup analyses to assess modification of the effects of BP lowering by time to treatment, treatment strategy and patient’s demographic, clinical and prestroke neuroradiological characteristics.Ethics and dissemination No new patient data will be collected nor is there any deviation from the original purposes of each study where ethical approvals were granted; therefore, further ethical approval is not required. Results will be reported in international peer-reviewed journals.PROSPERO registration number CRD42019141136.
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spelling doaj-art-716c07f1051c41daaaa9cea12bdad31f2024-11-22T20:55:09ZengBMJ Publishing GroupBMJ Open2044-60552019-07-019710.1136/bmjopen-2019-030121Lowering blood pressure after acute intracerebral haemorrhage: protocol for a systematic review and meta-analysis using individual patient data from randomised controlled trials participating in the Blood Pressure in Acute Stroke Collaboration (BASC)Keith W Muir0Gary Ford1Philip M Bath2Adnan I Qureshi3Thompson G Robinson4Rustam Al-Shahi Salman5Hisatomi Arima6Lisa J Woodhouse7Eivind Berge8Nikola Sprigg9Xia Wang10Tom J Moullaali11Zhe Kang Law12Candice Delcourt13Kailash Krishnan14Else C Sandset15Craig S Anderson16Yuko PaleschJohn Potter17Jeff SaverNerses SanossianKen Butcher18Kennedy R Lees19Janneke Horn20School of Psychology and Neuroscience, University of Glasgow, Glasgow, UK5Health Science Networks, Oxford University Hospitals, UK4 Stroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham, Nottinghamshire, UK3 Zeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, Missouri, USA1Cerebral Haemodynamics in Ageing and Stroke Medicine (CHiASM) Research Group, Department of Cardiovascular Sciences, University of Leicester, UK3 Edinburgh Clinical Trials Unit, The University of Edinburgh, Edinburgh, UKDepartment of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan1 Stroke, Division of Clinical Neurosciences, University of Nottingham, Nottingham, UK4 Department of Internal Medicine and Cardiology, Oslo University Hospital, Oslo, Norway1 Stroke, Division of Clinical Neurosciences, University of Nottingham, Nottingham, UKDepartment of Rheumatology, Royal North Shore Hospital, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, AustraliaThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, AustraliaStroke Trials Unit, Mental Health and Clinical Neurosciences, University of Nottingham, Nottingham, UKDepartment of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, AustraliaStroke, Nottingham University Hospitals NHS Trust, Nottingham, UKDepartment of Neurology, Oslo University Hospital, Oslo, NorwayGlobal Brain Health Program, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, AustraliaStroke Research Group, Norfolk and Norwich University Hospital, UKDepartment of Neurology, Liverpool Hospital, Ingham Institute for Applied Medical Research, University of New South Wales South Western Sydney Clinical School, Liverpool, New South Wales, Australiaprofessor of cerebrovascular medicineAmsterdam Neuroscience - Brain Imaging, Amsterdam, The NetherlandsIntroduction Conflicting results from multiple randomised trials indicate that the methods and effects of blood pressure (BP) reduction after acute intracerebral haemorrhage (ICH) are complex. The Blood pressure in Acute Stroke Collaboration is an international collaboration, which aims to determine the optimal management of BP after acute stroke including ICH.Methods and analysis A systematic review will be undertaken according to the Preferred Reporting Items for Systematic review and Meta-Analysis of Individual Participant Data (IPD) guideline. A search of Cochrane Central Register of Controlled Trials, EMBASE and MEDLINE from inception will be conducted to identify randomised controlled trials of BP management in adults with acute spontaneous (non-traumatic) ICH enrolled within the first 7 days of symptom onset. Authors of studies that meet the inclusion criteria will be invited to share their IPD. The primary outcome will be functional outcome according to the modified Rankin Scale. Safety outcomes will be early neurological deterioration, symptomatic hypotension and serious adverse events. Secondary outcomes will include death and neuroradiological and haemodynamic variables. Meta-analyses of pooled IPD using the intention-to-treat dataset of included trials, including subgroup analyses to assess modification of the effects of BP lowering by time to treatment, treatment strategy and patient’s demographic, clinical and prestroke neuroradiological characteristics.Ethics and dissemination No new patient data will be collected nor is there any deviation from the original purposes of each study where ethical approvals were granted; therefore, further ethical approval is not required. Results will be reported in international peer-reviewed journals.PROSPERO registration number CRD42019141136.https://bmjopen.bmj.com/content/9/7/e030121.full
spellingShingle Keith W Muir
Gary Ford
Philip M Bath
Adnan I Qureshi
Thompson G Robinson
Rustam Al-Shahi Salman
Hisatomi Arima
Lisa J Woodhouse
Eivind Berge
Nikola Sprigg
Xia Wang
Tom J Moullaali
Zhe Kang Law
Candice Delcourt
Kailash Krishnan
Else C Sandset
Craig S Anderson
Yuko Palesch
John Potter
Jeff Saver
Nerses Sanossian
Ken Butcher
Kennedy R Lees
Janneke Horn
Lowering blood pressure after acute intracerebral haemorrhage: protocol for a systematic review and meta-analysis using individual patient data from randomised controlled trials participating in the Blood Pressure in Acute Stroke Collaboration (BASC)
BMJ Open
title Lowering blood pressure after acute intracerebral haemorrhage: protocol for a systematic review and meta-analysis using individual patient data from randomised controlled trials participating in the Blood Pressure in Acute Stroke Collaboration (BASC)
title_full Lowering blood pressure after acute intracerebral haemorrhage: protocol for a systematic review and meta-analysis using individual patient data from randomised controlled trials participating in the Blood Pressure in Acute Stroke Collaboration (BASC)
title_fullStr Lowering blood pressure after acute intracerebral haemorrhage: protocol for a systematic review and meta-analysis using individual patient data from randomised controlled trials participating in the Blood Pressure in Acute Stroke Collaboration (BASC)
title_full_unstemmed Lowering blood pressure after acute intracerebral haemorrhage: protocol for a systematic review and meta-analysis using individual patient data from randomised controlled trials participating in the Blood Pressure in Acute Stroke Collaboration (BASC)
title_short Lowering blood pressure after acute intracerebral haemorrhage: protocol for a systematic review and meta-analysis using individual patient data from randomised controlled trials participating in the Blood Pressure in Acute Stroke Collaboration (BASC)
title_sort lowering blood pressure after acute intracerebral haemorrhage protocol for a systematic review and meta analysis using individual patient data from randomised controlled trials participating in the blood pressure in acute stroke collaboration basc
url https://bmjopen.bmj.com/content/9/7/e030121.full
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