| Title: |
Hypertension Treatment Intensification Among Stroke Survivors With Uncontrolled Blood Pressure |
| Authors: |
Roumie, Christianne L.; Zillich, Alan J.; Bravata, Dawn M.; Jaynes, Heather A.; Myers, Laura J.; Yoder, Joseph; Cheng, Eric M. |
| Source: |
Stroke ; volume 46, issue 2, page 465-470 ; ISSN 0039-2499 1524-4628 |
| Publisher Information: |
Ovid Technologies (Wolters Kluwer Health) |
| Publication Year: |
2015 |
| Description: |
Background and Purpose— We examined blood pressure 1 year after stroke discharge and its association with treatment intensification. Methods— We examined the systolic blood pressure (SBP) stratified by discharge SBP (≤140, 141–160, or >160 mm Hg) among a national cohort of Veterans discharged after acute ischemic stroke. Hypertension treatment opportunities were defined as outpatient SBP >160 mm Hg or repeated SBPs >140 mm Hg. Treatment intensification was defined as the proportion of treatment opportunities with antihypertensive changes (range, 0%–100%, where 100% indicates that each elevated SBP always resulted in medication change). Results— Among 3153 patients with ischemic stroke, 38% had ≥1 elevated outpatient SBP eligible for treatment intensification in the 1 year after stroke. Thirty percent of patients had a discharge SBP ≤140 mm Hg, and an average 1.93 treatment opportunities and treatment intensification occurred in 58% of eligible visits. Forty-seven percent of patients discharged with SBP 141 to160 mm Hg had an average of 2.1 opportunities for intensification and treatment intensification occurred in 60% of visits. Sixty-three percent of the patients discharged with an SBP >160 mm Hg had an average of 2.4 intensification opportunities, and treatment intensification occurred in 65% of visits. Conclusions— Patients with discharge SBP >160 mm Hg had numerous opportunities to improve hypertension control. Secondary stroke prevention efforts should focus on initiation and review of antihypertensives before acute stroke discharge; management of antihypertensives and titration; and patient medication adherence counseling. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1161/strokeaha.114.007566 |
| DOI: |
10.1161/STROKEAHA.114.007566 |
| Availability: |
https://doi.org/10.1161/strokeaha.114.007566; https://www.ahajournals.org/doi/full/10.1161/STROKEAHA.114.007566 |
| Accession Number: |
edsbas.1C273F7E |
| Database: |
BASE |