Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

Health Services Research & Development

Go to the ORD website
Go to the QUERI website

HSR&D Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

Predictors of Optimal Post-Stroke Hypertension Control

Sico J, Myers L, Concato J, Williams LS, Bravata DM. Predictors of Optimal Post-Stroke Hypertension Control. [Abstract]. Stroke; A Journal of Cerebral Circulation. 2015 Apr 1; 46(4):ATP140.


Introduction: Significant patient- and facility-level predictors of optimal post-stroke hypertension (HTN) control have not been identified; their identification may inform future intervention studies. Methods: This was a secondary analysis of a retrospective cohort study that included 3965 Veterans who were admitted with ischemic stroke at 131 Veterans Health Administration (VHA) facilities (fiscal year 2007). Blood pressure (BP) values at 6-month post-stroke were used to define optimal ( < 140/90 mmHg) and suboptimal ( 140/90 mmHg) control among patients with a history of HTN. Among facilities that admitted at least 25 stroke patients annually, we used multivariate logistic regression with backward elimination to identify patient- (e.g., stroke severity) and facility-level (e.g., hospital level complexity) characteristics that independently predicted optimal BP control 6-months post-stroke while adjusting for age, race, marital status, and post-stroke follow-up care. Results: A total of 2541 (64.1%) patients had a history of HTN, with 33.4% of patients achieving goal BP at 6-months. A past medical history of congestive heart failure (CHF; adjusted OR [aOR]: 2.5, 95% CI: 1.02 to 6.26; p = 0.046) and being discharged on a lipid lowering agent (aOR: 2.5, 95% CI: 1.26 to 5.03) were associated with optimal BP control 6-months post-stroke. Admission stroke severity (aOR: 0.998, 95% CI: 0.996-1.110), Charlson comorbidity score (aOR: 0.875, 95% CI: 0.59-1.30), past history of ischemic stroke (aOR: 1.41, 95% CI: 0.74-2.67), and medical record documentation of a post-discharge plan for HTN management (aOR: 1.00, 95% CI: 0.99-1.02; p = 0.47) were not predictive of optimal BP control. Facility-level characteristics, including hospital level complexity (aOR: 0.998, 95% CI: 0.992-1.005; p = 0.16) and the number of stroke patients seen annually at a facility (aOR 0.997, 95% CI: 0.993-1.001; p = 0.17) were also not associated with optimal post-stroke BP control. Conclusions: Future work should seek to understand why current approaches to improving post-stroke BP control are inadequate for a majority of patients and whether lessons might be learned from the care of patients with stroke and CHF that could be applied to the general post-stroke population.

Questions about the HSR&D website? Email the Web Team.

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.