Conference Coverage

Nearly Half of U.S. Stroke Patients Remain Hypertensive



NEW ORLEANS – Nearly half of adult Americans who self-reported a history of stroke also had poorly-controlled hypertension, based on a review of data collected from a U.S. nationwide sample during 1999-2004.

In addition, another 8% of stroke survivors had undiagnosed hypertension, Dr. Amytis Towfighi and her associates reported in a poster at the International Stroke Conference.

Dr. Amytis Towfighi

"Several medical and lifestyle modification factors could be potential targets of intervention to bridge this evidence practice gap," said Dr. Towfighi, a neurologist at the University of Southern California, Los Angeles and director of the acute neurology/acute stroke unit at Rancho Los Amigos National Rehabilitation Center in Downey, Calif.

Dr. Towfighi and her associates used data collected in the National Health and Nutrition Examination Survey (NHANES) during 1999-2004. Among the 9,145 Americans aged 40 years or older included in the NHANES surveys during those years, 490 (5%) self-reported a history of stroke.

Within this subgroup of stroke survivors, 72% said that they had been diagnosed with hypertension, and 47% had hypertension that was poorly controlled, with a blood pressure at the time of NHANES data collected that exceeded 140/90 mm Hg. An additional 8% of the stroke survivors had hypertension based on their NHANES data but did not self-report a previous diagnosis of hypertension.

Mortality follow-up of the 490 stroke patients through the end of 2006 showed that the mortality rates of these people did not differ significantly regardless of their initially measured blood pressure in the NHANES survey, nor by the number of antihypertensive medications these people reported receiving at baseline.

A multivariate analysis that adjusted for several demographic and clinical features identified Hispanic ethnicity, female sex, and diabetes as correlates of poor hypertension control, while hyperlipidemia and male gender were correlates of stroke patients not receiving any antihypertensive medications.

Dr. Towfighi said that she had no disclosures.

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