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Increased blood pressure (BP) variability, in addition to high BP, may contribute to adverse outcome in intracerebral hemorrhage. However, degree and association with outcome of BP variability (BPV) in the hyperacute period, 15 minutes to 5 hours after onset, have not been delineated.

Among consecutive patients with intracerebral hemorrhage enrolled in the FAST-MAG trial (Field Administration of Stroke Therapy-Magnesium), BPs were recorded by paramedics in the field and during the first 24 hours of hospital course. BP was analyzed in the hyperacute period, from 0 to 4–6 hours, and in the acute period, from 0 to 24–26 hours after onset. BPV was analyzed by SD, coefficient of variation, and successive variation.

Among 386 patients with intracerebral hemorrhage, first systolic BP at median 23 minutes (interquartile range, 14–38.5) after onset was median 176 mm Hg …