Enhanced Versus Standard Blood Pressure Lowering on Intracranial Aneurysm Rupture or Growth
The goal of this randomized controlled trial is to evaluate the benefits and safety of controlled hypotension in Chinese patients with unruptured intracranial aneurysms(UIA). The main questions it aims to answer are: * To provide high-level evidence of the benefits and safety of controlled hypotension in patients with UIA. * To provide evidence-based medical evidence for blood pressure control of patients with UIA in neurosurgery, and promote the progress of accurate individual management of patients. In this study, the main intervention is enhanced blood pressure lowering in patients with UIA. All Patients will be randomly assigned to either the standard blood pressure lowering (SBPL) group or the enhanced blood pressure lowering (EBPL) group.
• Age 18-75.
• Chinese ethnicity.
• Unruptured saccular intracranial aneurysm (UIA) identified by computational tomography angiography, magnetic resonance angiography or digital subtraction angiography.
‣ Maximal size of UIA at largest dimension \< 7 mm
⁃ The morphology of UIA is regular (no bleb(s) or secondary aneurysm(s) protruding from the UIA fundus or bi-/ multi-lobular UIA fundus)
⁃ UIA receiving conservative treatment
• History of primary hypertension (as diagnosed per standard of care)
• Systolic blood pressure (SBP) on 2 consecutive visits:
• SBP: 130-180 mmHg on 0 or 1 antihypertensive medication. SBP: 130-170 mmHg on up to 2 antihypertensive medications. SBP: 130-160 mmHg on up to 3 antihypertensive medications. SBP: 130-150 mmHg on up to 4 antihypertensive medications
• Good medication adherence (Morisky Medication Adherence Scale ≥6)
• Obtain informed consent from patient or legal representative