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In a big development in stroke care, researchers from HKU Stroke and the Division of Medication, College of Medical Medication on the LKS College of Medication of the College of Hong Kong (HKUMed) have developed the TRICH rating.
This modern scientific software is designed to assist physicians successfully determine intracerebral hemorrhage (ICH) sufferers who would profit from early prescription of triple antihypertensive remedy.
The TRICH rating addresses a crucial want in hypertension care after ICH by facilitating well timed and efficient blood stress management. It additionally has the potential to considerably cut back the chance of ICH recurrence and subsequent strokes.
The findings are revealed within the Neurology.
Along with the TRICH Rating, HKU Stroke is conducting a separate research on the usage of telemedicine for hypertension administration in ICH sufferers, additional enhancing their strategy to affected person care.
ICH, the second commonest type of stroke, accounts for 50% of all stroke-related deaths in Asian nations and is a serious reason for long-term incapacity. Efficient blood stress management after ICH is pivotal for enhancing long-term outcomes, however it may be difficult as a result of many sufferers usually expertise extreme hypertension.
Earlier analysis by HKU Stroke confirmed that almost all ICH sufferers fail to manage their blood stress, considerably rising the chance of ICH recurrence, subsequent strokes and loss of life. A minimum of three antihypertensive drugs are sometimes wanted, however many sufferers don’t obtain acceptable remedy for varied causes.
There are additionally considerations in regards to the dangers of overtreatment and extreme discount in blood stress, which may result in extra unwanted side effects, notably in older sufferers.
The TRICH rating was developed by MBBS college students Adrian So Ching-hei and Charming Yeung underneath the supervision of Dr. Teo Kay-cheong, Medical Assistant Professor of the Division of Medication, College of Medical Medication at HKUMed, and Deputy Director of HKU Stroke.
This scientific software has been validated in three native hospitals—Ruttonjee Hospital, Yan Chai Hospital and Princess Margaret Hospital—based mostly on a cohort of 462 ICH sufferers at Queen Mary Hospital.
The TRICH rating includes 5 easy scientific predictors: age, intercourse, kidney operate, admission blood stress, and the presence of ischemic coronary heart illness. This scoring system permits well being care suppliers to determine sufferers who want aggressive remedy shortly, facilitating immediate blood stress administration whereas minimizing the dangers related to overtreatment and drugs unwanted side effects in lower-risk circumstances.
Dr. Teo emphasised the significance of efficient blood stress management after an ICH. “This empowers doctors to give the right treatment at the right time,” he defined. Since ICH sufferers usually expertise extra extreme hypertension, new approaches to managing hypertension on this inhabitants are wanted.
“Patients with poorly controlled hypertension face up to four times greater risk of ICH and stroke, which can lead to significant disability or death,” he stated. “The TRICH score can guide clinicians to adopt early prescription of triple antihypertensive medications. Using combination antihypertensive pills is preferred to enhance drug compliance.”
Dr. Teo highlighted the function of telemedicine in enhancing hypertension administration. Along with the TRICH rating, HKU Stroke is pioneering the MOBILE-ICH (MOBILE well being intervention in IntraCerebral Hemorrhage survivors) research, to research the security and efficacy of telemedicine for managing hypertension in ICH sufferers.
“As an undergraduate medical student, I find it incredibly rewarding to realize that my research during my Enrichment Year could significantly impact clinical practice and patient outcomes,” stated Adrian So, who performed the analysis throughout his 12 months 3 Enrichment 12 months (EY).
Charming Yeung, who simply graduated from HKUMed and can start working as a health care provider in July this yr, echoed this sentiment: “The research journey over the past three years has been challenging, but I’ve gained valuable knowledge and found the experience worthwhile and meaningful.”
On condition that ICH is a extreme situation, prevention can also be essential. Efficient screening and administration of hypertension in most of the people can considerably decrease the chance of creating this illness. Sadly, a separate research discovered that as much as 80% of ICH sufferers aged 55 or youthful have undiagnosed or untreated hypertension.
Dr. Gary Lau Kui-kai, Director of HKU Stroke and Medical Affiliate Professor in Neurology on the Division of Medication, College of Medical Medication at HKUMed, underscored the need of addressing hypertension not solely in stroke sufferers but in addition within the basic inhabitants.
He acknowledged, “Hypertension, the leading modifiable risk factor for stroke today, often goes unnoticed. Many stroke patients, particularly younger individuals, have undiagnosed or untreated hypertension. The stroke could be prevented with the early intervention of hypertension.”
Extra data:
Ching Hei So et al, Triple Antihypertensive Remedy Prediction Rating After Intracerebral Hemorrhage (the TRICH Rating), Neurology (2025). DOI: 10.1212/WNL.0000000000213560
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The College of Hong Kong
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Telemedicine and new scoring system supply hope for safer post-stroke hypertension administration (2025, Could 12)
retrieved 13 Could 2025
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