Blood Pressure Control among Stroke Patients in Thailand—The i-STROKE Study

• Published in: Journal of stroke and cerebrovascular diseases 2014-03, Vol.23 (3), p.476-483
• Main Authors: Nidhinandana, Samart, MD, Ratanakorn, Disya, MD, Charnnarong, Nijasri, MD, Muengtaweepongsa, Sombat, MD, Towanabut, Somchai, MD
• Format: Article
• Language: English
• Subjects: Aged; Antihypertensive Agents - therapeutic use; Awareness; Blood Pressure - drug effects; Blood pressure control; Cardiovascular; Chi-Square Distribution; Cross-Sectional Studies; Drug Utilization Review; Female; Guideline Adherence; Health Knowledge, Attitudes, Practice; Humans; Hypertension - diagnosis; Hypertension - drug therapy; Hypertension - mortality; Hypertension - physiopathology; hypertension management; Incidence; Logistic Models; Male; Middle Aged; Multivariate Analysis; Neurology; Odds Ratio; Patient Discharge; Patient Education as Topic; Practice Guidelines as Topic; Practice Patterns, Physicians; Retrospective Studies; Risk Factors; stroke; Stroke - diagnosis; Stroke - mortality; Stroke - physiopathology; Stroke - therapy; Thailand; Thailand - epidemiology; Time Factors; Treatment Outcome
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2013.04.006

Background Direct correlation between stroke mortality and hypertension calls for a tight blood pressure (BP) control. Our study determined the prevalence of the BP control and evaluated current clinical practices on hypertension management in stroke patients in Thailand. Methods This multicenter, cross-sectional, retrospective, observational study was carried out between February 2010 and January 2011 and enrolled stroke patients aged 45 years or older with ictus incidence 12,030 days before the enrollment. The events were confirmed by either computerized tomography scan or magnetic resonance imaging. Patient data including demographics, medical, and clinical history were collected. Results At enrollment, 274 of 558 (49.1%) patients had controlled arterial BP with an average pressure of 134.220.4/78.812.8 mm Hg; 412 (73.8%) patients received antihypertensive medications and the most common use was angiotensin-converting enzyme inhibitors (ACEIs), reported in 200 (35.8%) patients. With questionnaire, insufficient antihypertensive use and lack of patients' awareness were the 2 most common reasons given by physicians for the patients' uncontrolled BP. Factors identified to have adverse association with the controlled BP at enrollment were diabetes at baseline, stage II hypertension, stage I hypertension, and the use of ACEIs at discharge (odds ratio of .18, .24, .30 [ P