Hypertension Prevalence, Treatment, and Control 90 Days After Acute Stroke Among Mexican American and Non‐Hispanic White Adults
Background High blood pressure (BP) increases recurrent stroke risk. Methods and Results We assessed hypertension prevalence, treatment, control, medication adherence, and predictors of uncontrolled BP 90 days after ischemic or hemorrhagic stroke among 561 Mexican American and non‐Hispanic White (NH...
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| Language: | English |
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Wiley
2024-08-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.034252 |
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| author | Mellanie V. Springer Deborah A. Levine Dehua Han Lynda D. Lisabeth Lewis B. Morgenstern Robert D. Brook Devin L. Brown Darin B. Zahuranec William J. Meurer Erin Case Rachael Whitney |
| author_facet | Mellanie V. Springer Deborah A. Levine Dehua Han Lynda D. Lisabeth Lewis B. Morgenstern Robert D. Brook Devin L. Brown Darin B. Zahuranec William J. Meurer Erin Case Rachael Whitney |
| author_sort | Mellanie V. Springer |
| collection | DOAJ |
| description | Background High blood pressure (BP) increases recurrent stroke risk. Methods and Results We assessed hypertension prevalence, treatment, control, medication adherence, and predictors of uncontrolled BP 90 days after ischemic or hemorrhagic stroke among 561 Mexican American and non‐Hispanic White (NHW) survivors of stroke from the BASIC (Brain Attack Surveillance in Corpus Christi) cohort from 2011 to 2014. Uncontrolled BP was defined as average BP ≥140/90 mm Hg at 90 days poststroke. Hypertension was uncontrolled BP or antihypertensive medication prescribed or hypertension history. Treatment was antihypertensive use. Adherence was missing zero antihypertensive doses per week. We investigated predictors of uncontrolled BP using logistic regression adjusting for patient factors. Median (interquartile range) age was 68 (59–78) years, 64% were Mexican American, and 90% of strokes were ischemic. Overall, 94.3% of survivors of stroke had hypertension (95.6% Mexican American versus 92.0% non‐Hispanic White; P=0.09). Of these, 87.9% were treated (87.3% Mexican American versus 89.1% non‐Hispanic White; P=0.54). Among the total population, 38.3% (95% CI, 34.4%–42.4%) had uncontrolled BP. Among those with uncontrolled BP prescribed an antihypertensive, 84.5% reported treatment adherence (95% CI, 78.8%–89.3%). Uncontrolled BP 90 days poststroke was less likely in patients with stroke who had a primary care physician (adjusted odds ratio [aOR], 0.45 [95% CI, 0.24–0.83]; P=0.01), greater stroke severity (aOR per‐1‐point‐higher National Institutes of Health Stroke Scale score, 0.96 [95% CI, 0.93–0.99]; P=0.02), or more depressive symptoms (aOR per‐1‐point‐higher Personal Health Questionnaire Depression Scale‐8 score, 0.95 [95% CI, 0.92–0.99] among those with a history of hypertension at baseline; P=0.009). Conclusions Greater than one third of survivors of stroke have uncontrolled BP at 90 days poststroke in this population‐based study. Interventions are needed to improve BP control after stroke. |
| format | Article |
| id | doaj-art-7c25ffb4dcf04d018b3e6dba08e07b46 |
| institution | OA Journals |
| issn | 2047-9980 |
| language | English |
| publishDate | 2024-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-7c25ffb4dcf04d018b3e6dba08e07b462025-08-20T01:54:16ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-08-01131610.1161/JAHA.124.034252Hypertension Prevalence, Treatment, and Control 90 Days After Acute Stroke Among Mexican American and Non‐Hispanic White AdultsMellanie V. Springer0Deborah A. Levine1Dehua Han2Lynda D. Lisabeth3Lewis B. Morgenstern4Robert D. Brook5Devin L. Brown6Darin B. Zahuranec7William J. Meurer8Erin Case9Rachael Whitney10Department of Neurology and Stroke Program University of Michigan Ann Arbor MI USADepartment of Neurology and Stroke Program University of Michigan Ann Arbor MI USADepartment of Internal Medicine and Cognitive Health Services Research Program University of Michigan Ann Arbor MI USADepartment of Neurology and Stroke Program University of Michigan Ann Arbor MI USADepartment of Neurology and Stroke Program University of Michigan Ann Arbor MI USADepartment of Internal Medicine Wayne State University Detroit MI USADepartment of Neurology and Stroke Program University of Michigan Ann Arbor MI USADepartment of Neurology and Stroke Program University of Michigan Ann Arbor MI USADepartment of Emergency Medicine University of Michigan Ann Arbor MI USADepartment of Epidemiology University of Michigan Ann Arbor MI USADepartment of Internal Medicine and Cognitive Health Services Research Program University of Michigan Ann Arbor MI USABackground High blood pressure (BP) increases recurrent stroke risk. Methods and Results We assessed hypertension prevalence, treatment, control, medication adherence, and predictors of uncontrolled BP 90 days after ischemic or hemorrhagic stroke among 561 Mexican American and non‐Hispanic White (NHW) survivors of stroke from the BASIC (Brain Attack Surveillance in Corpus Christi) cohort from 2011 to 2014. Uncontrolled BP was defined as average BP ≥140/90 mm Hg at 90 days poststroke. Hypertension was uncontrolled BP or antihypertensive medication prescribed or hypertension history. Treatment was antihypertensive use. Adherence was missing zero antihypertensive doses per week. We investigated predictors of uncontrolled BP using logistic regression adjusting for patient factors. Median (interquartile range) age was 68 (59–78) years, 64% were Mexican American, and 90% of strokes were ischemic. Overall, 94.3% of survivors of stroke had hypertension (95.6% Mexican American versus 92.0% non‐Hispanic White; P=0.09). Of these, 87.9% were treated (87.3% Mexican American versus 89.1% non‐Hispanic White; P=0.54). Among the total population, 38.3% (95% CI, 34.4%–42.4%) had uncontrolled BP. Among those with uncontrolled BP prescribed an antihypertensive, 84.5% reported treatment adherence (95% CI, 78.8%–89.3%). Uncontrolled BP 90 days poststroke was less likely in patients with stroke who had a primary care physician (adjusted odds ratio [aOR], 0.45 [95% CI, 0.24–0.83]; P=0.01), greater stroke severity (aOR per‐1‐point‐higher National Institutes of Health Stroke Scale score, 0.96 [95% CI, 0.93–0.99]; P=0.02), or more depressive symptoms (aOR per‐1‐point‐higher Personal Health Questionnaire Depression Scale‐8 score, 0.95 [95% CI, 0.92–0.99] among those with a history of hypertension at baseline; P=0.009). Conclusions Greater than one third of survivors of stroke have uncontrolled BP at 90 days poststroke in this population‐based study. Interventions are needed to improve BP control after stroke.https://www.ahajournals.org/doi/10.1161/JAHA.124.034252dementiamild cognitive impairmentquality of health carestroke |
| spellingShingle | Mellanie V. Springer Deborah A. Levine Dehua Han Lynda D. Lisabeth Lewis B. Morgenstern Robert D. Brook Devin L. Brown Darin B. Zahuranec William J. Meurer Erin Case Rachael Whitney Hypertension Prevalence, Treatment, and Control 90 Days After Acute Stroke Among Mexican American and Non‐Hispanic White Adults Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease dementia mild cognitive impairment quality of health care stroke |
| title | Hypertension Prevalence, Treatment, and Control 90 Days After Acute Stroke Among Mexican American and Non‐Hispanic White Adults |
| title_full | Hypertension Prevalence, Treatment, and Control 90 Days After Acute Stroke Among Mexican American and Non‐Hispanic White Adults |
| title_fullStr | Hypertension Prevalence, Treatment, and Control 90 Days After Acute Stroke Among Mexican American and Non‐Hispanic White Adults |
| title_full_unstemmed | Hypertension Prevalence, Treatment, and Control 90 Days After Acute Stroke Among Mexican American and Non‐Hispanic White Adults |
| title_short | Hypertension Prevalence, Treatment, and Control 90 Days After Acute Stroke Among Mexican American and Non‐Hispanic White Adults |
| title_sort | hypertension prevalence treatment and control 90 days after acute stroke among mexican american and non hispanic white adults |
| topic | dementia mild cognitive impairment quality of health care stroke |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.034252 |
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