The impacts of premorbid hypertension treatment on functional outcomes of ischemic stroke

• Published in: Journal of the neurological sciences 2016-04, Vol.363, p.1-4
• Main Authors: Cao, Qinqin, Zhou, Shuyu, Cai, Biyang, Wang, Qing, Zhang, Jun, Shi, Ruifeng, Liu, Keting, Liu, Xinfeng, Xu, Gelin
• Format: Article
• Language: English
• Subjects: Aged; Antihypertensive Agents - administration & dosage; Brain Ischemia - diagnosis; Brain Ischemia - epidemiology; Brain Ischemia - prevention & control; China - epidemiology; Female; Follow-Up Studies; Functional outcomes; Humans; Hypertension; Hypertension - diagnosis; Hypertension - drug therapy; Hypertension - epidemiology; Ischemic stroke; Male; Middle Aged; Neurology; Pre-Exposure Prophylaxis - trends; Recovery of Function - drug effects; Recovery of Function - physiology; Registries; Retrospective Studies; Risk factors; Stroke - diagnosis; Stroke - epidemiology; Stroke - prevention & control; Treatment Outcome
• ISSN: 0022-510X; 1878-5883
• DOI: 10.1016/j.jns.2016.02.020

Abstract Background and purpose The low rate of hypertension control is a major cause for the high rate of stroke morbidity and mortality in China. This study aimed to evaluate the impacts of premorbid hypertension treatment on the functional outcomes in patients with acute ischemic stroke and hypertension. Methods Patients with first-ever ischemic stroke and hypertension were screened from Nanjing Stroke Registry Program for eligibility. Functional outcomes were followed at 3 months with modified Rankin Scale (mRS). A good functional outcome was defined as mRS ≤ 2. Potential factors associated with good functional outcomes were analyzed with multivariate logistic regression. Results A total of 660 patients with both ischemic stroke and hypertension were included, of whom 284 (43.0%) were on antihypertensives before stroke. In univariate analysis, more patients with hypertension treatments had good outcomes than those without (47.7% vs 31.0%, P = 0.0001). After adjusted for age, heart diseases, baseline stroke severity, systolic blood pressure at admission, pneumonia, intravenous thrombolysis, and hospital stay, multivariate logistic regression indicated that premorbid hypertension treatment was related to an increased likelihood of good functional outcomes (OR: 2.21, 95% CI: 1.30 to 3.74, P = 0.003). Conclusions Less than half of the Chinese patients with hypertension were on drug treatment prior to stroke onset. Lack of premorbid hypertension treatment may have deteriorated functional outcomes of stroke. These findings emphasized the importance of improving hypertension treatment in Chinese, especially in whom at high risk of cerebrovascular diseases.