INTERACT4 Trial
Intensive Ambulance-Delivered Blood-Pressure Reduction in Hyperacute Stroke
A multicentre, randomized, open-label trial
Objective:
To determine the effect of prehospital treatment of elevated systolic blood pressure (SBP) in patients with recent onset of symptoms concerning for acute stroke.
2404 Patients
Inclusion Criteria:
- Age ≥18 years
- Acute stroke with FAST score ≥2 causing a motor deficit
- Symptom onset within 2 hours
- SBP ≥150
Exclusion Criteria:
- GCS ≤5
- Severe comorbidities
- History of epilepsy or new seizure at onset
- Hypoglycemia
- History of recent head injury
Groups
- Intervention Group (Ambulance-delivered antihypertensive therapy):
- n = 1205
- Usual-Care Group:
- n = 1199
Outcomes
Primary Outcome:
- Difference in functional outcome
- Odds Ratio: 1.00
- 95% CI: 0.87-1.15
- P = 0.16
Secondary Outcomes:
- Poor functional outcome among patients with hemorrhagic stroke:
- Odds Ratio: 0.75
- 95% CI: 0.60 to 0.92
- Poor functional outcome among patients with ischemic stroke or TIA:
- Odds Ratio: 1.30
- 95% CI: 1.06 to 1.60
Conclusion:
In this trial, prehospital blood-pressure reduction did not improve functional outcomes in a cohort of patients with undifferentiated acute stroke.
Source: