This Article Full Text Full Text (PDF) All Versions of this Article: 36/9/1944    most recent 01.STR.0000177522.80092.b7v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ovbiagele, B. Articles by Johnston, S. C. Search for Related Content PubMed PubMed Citation Articles by Ovbiagele, B. Articles by Johnston, S. C. Pubmed/NCBI databases Medline Plus Health Information Blood Pressure Medicines Transient Ischemic Attack Related Collections Cerebrovascular disease/stroke Risk Factors Other hypertension Risk Factors for Stroke Other Stroke Treatment - Medical Transient Ischemic Attacks

(Stroke. 2005;36:1944.)
© 2005 American Heart Association, Inc.

Original Contributions

Antihypertensive Medications Prescribed at Discharge After an Acute Ischemic Cerebrovascular Event

Bruce Ovbiagele, MD; Nancy K. Hills, PhD, MBA; Jeffrey L. Saver, MD S. Claiborne Johnston, MD, PhD

From the Stroke Center and Department of Neurology (B.O., J.L.S.), UCLA Medical Center, Los Angeles, Calif; Department of Neurology (B.O., J.L.S.), Olive View—UCLA Medical Center, Los Angeles, Calif; and Department of Neurology (N.K.H., S.C.J.), University of California, San Francisco.

Correspondence to Bruce Ovbiagele, MD, Stroke Center and Department of Neurology, University of California at Los Angeles, 710 Westwood Plaza, Los Angeles, CA 90095. E-mail ovibes{at}mednet.ucla.edu

Background and Purpose— Hypertension is poorly controlled in stroke survivors, thereby placing them at increased risk for recurrent events. Clinical trial evidence suggests that antihypertensive treatment may be beneficial for stroke prevention in hypertensive and normotensive stroke patients. We aimed to evaluate the discharge antihypertensive prescription patterns in patients hospitalized for an ischemic cerebrovascular event and to determine factors associated with treatment utilization.

Methods— We analyzed patients diagnosed with ischemic stroke or transient ischemic attack (TIA) in the California Acute Stroke Prototype Registry (CASPR). We used generalized estimating equations to identify factors independently associated with receiving antihypertensives at the time of hospital discharge.

Results— Data were collected on 764 consecutive patients with ischemic stroke or TIA encountered at 11 hospitals representative of facilities in the state of California. Overall, the rate of discharge with a prescription for any antihypertensive in the CASPR cohort was 69.4%. Hospital-specific rates were heterogeneous (P=0.04), varying from 55% to 100%. In multivariate analysis, independent predictors of prescription for antihypertensive medication at discharge were a history of hypertension (P<0.0001), diabetes (P=0.0009), and older age.

Conclusions— About two-thirds of patients hospitalized with acute ischemic cerebrovascular events are discharged from the hospital on 1 antihypertensive medication. However, there is great variability in prescription rates between hospitals and considerable room for improvement.

Key Words: hypertension • secondary prevention • stroke

This article has been cited by other articles:

				A. I. Qureshi Acute Hypertensive Response in Patients With Stroke: Pathophysiology and Management Circulation, July 8, 2008; 118(2): 176 - 187. [Full Text] [PDF]

				S. E. Ramsay, P. H. Whincup, S. G. Wannamethee, O. Papacosta, L. Lennon, M. C. Thomas, and R. W. Morris Missed opportunities for secondary prevention of cerebrovascular disease in elderly British men from 1999 to 2005: a population-based study J. Public Health Med., September 1, 2007; 29(3): 251 - 257. [Abstract] [Full Text] [PDF]