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May 27, 2026Cerebrovascular Diseases

Blood pressure lowering for the prevention of REcurrent stroke and Cardiovascular outcomes After acute intracerebral haemorrhage: protocol for an individual Participant data meta-analysis of randomised controlled trials (RECAP-ICH)

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Why the study?

Although long-term BP lowering benefits patients after acute spontaneous ICH, uncertainty remains regarding treatment effect variation by patient characteristics, across various CV and non-CV outcomes, and the timing of benefits.

Does blood pressure-lowering therapy reduce the risk of recurrent stroke and major cardiovascular events in patients with a history of intracerebral hemorrhage?

Population

Patients with ICH from RCTs enrolling at least 100 participants with ICH

Comparison

BP-lowering therapy vs control

Design

Protocol for an individual participant data meta-analysis of RCTs

Key result

This protocol outlines an individual participant data meta-analysis to determine the efficacy of blood pressure lowering for secondary prevention after intracerebral hemorrhage.

Authors

MVMJ VelascoYGYijie GaoSLShitian Li

Discussion

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Member takes

Overview

Planned IPD meta-analysis will guide post-ICH BP targets; extends aggregate data with timing and subgroup insights.

Key Points

  • To determine the efficacy of blood pressure lowering for secondary prevention of major cardiovascular events in patients with a history of intracerebral hemorrhage.
  • Conducted a systematic review per PRISMA-IPD guidelines.
  • Searched multiple databases for randomized controlled trials with at least 100 patients with ICH.
  • Planned an individual participant data meta-analysis using major RCTs including TRIDENT, ESPRIT, PROGRESS, and RESPECT.
  • Primary outcome is time to first recurrent stroke; secondary outcomes include major adverse cardiovascular events such as non-fatal stroke and myocardial infarction.
  • Utilizing a Cox proportional hazards model for analysis, adjusting for important factors like age, hypertension, and diabetes.
  • Sensitivity analyses will address death as a competing risk to better understand the benefits over time.

Study Design

Type

Meta-Analysis

Multicenter

Yes

Structured PICO

Does blood pressure-lowering therapy reduce the risk of recurrent stroke and major cardiovascular events in patients with a history of intracerebral hemorrhage?

P
Population
Patients with a history of acute spontaneous intracerebral hemorrhage (ICH) from randomized controlled trials that enrolled at least 100 participants with ICH.
I
Intervention
Blood pressure-lowering therapy for secondary prevention.
C
Comparator
Control groups from the included randomized controlled trials.
O
Outcome
Time to first recurrent stroke of any type.hard clinical

This protocol outlines a planned individual participant data meta-analysis to determine the efficacy, optimal timing, and subgroup variations of blood pressure-lowering therapy for secondary prevention after intracerebral hemorrhage.

Cite This Study

Velasco et al. (2026) conducted a meta-analysis in Acute spontaneous intracerebral hemorrhage. Blood pressure lowering therapy was evaluated on Time to first recurrent stroke of any type. This protocol outlines an individual participant data meta-analysis to determine the efficacy of blood pressure lowering for secondary prevention after intracerebral hemorrhage.

synapsesocial.com/papers/6a168a9c0c924ddd1bd595f1https://doi.org/10.1159/000552671
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