Abstract W P334: Admission Blood Pressure Predicts The Number Of Medications Upon Discharge In Patients With Primary Intracerebral Hemorrhage
Background and Purpose: Previous studies have shown that controlling blood pressure (BP) may limit hematoma expansion in primary ICH. We hypothesize that aggressive management requires multiple BP medications and sought to evaluate what factors are associated with the number of BP medications at discharge.
Methods: Patients with primary ICH admitted to our center from 2008-2013 were included. Patients whose care was transitioned to palliative medicine were excluded. Primary outcome of interest was the number of BP medications at discharge. Poisson distribution was used to assess the relationship between baseline variables and number of BP meds at discharge.
Results: A total of 288 patients met eligibility criteria. The median age of the population of 62, 44.2% females, and 47.9% patients of African-American ethnicity. There were 236 patients (81.9%) with a history of hypertension (HTN). Patients with HTN had a higher admission systolic blood pressure (SBP) compared to those without HTN (180 vs. 157; p=0.0001). Number of BP medications at discharge ranged from 0-7, with the majority of patients discharged on 3 or more meds (29.9%). Only 4% of patients were discharged with no BP medications, whereas 7.3% were discharged on 5 or more. The only baseline variables that were significantly associated with number of BP meds on discharge in univariable analyses were a history of HTN (p<0.0001) and admission SBP (p<0.0001). In patients without a history of HTN, every 10-point increase in SBP on arrival resulted in an increase in 0.5 BP meds at the time of discharge (p=0.0011). For patients with a history of HTN, each 10-point increase in SBP on arrival resulted in an increase in 1.3 BP meds at the time of discharge (p=0.0012).
Conclusions: A history of hypertension and admission systolic blood pressure were significant predictors of the number of BP medications at discharge. Admission SBP was also significantly associated with the number of BP medications on discharge for patients without a history of hypertension. Further research is needed to assess if the BP elevation is a stress response in patients without hypertension, or an indicator of uncontrolled hypertension in patients with a history of hypertension.
Author Disclosures: A. Khawaja: None. A.K. Boehme: None. K.C. Albright: None. R. Bavarsad Shahripour: None. G. Kumar: None. H. Shiue: None. M. Lyerly: None. A. Hays: None. M. Harrigan: None.
- © 2015 by American Heart Association, Inc.