Abstract Details

Title The Factors Associated with Blood Pressure Control after Discharge for Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P04 - (-)

Poster/Presentation
Number 081

Objective

Background BACKGROUND: Hypertension is the most important modifiable risk factor for secondary stroke prevention yet few studies address blood pressure control after a stroke or TIA.

Design/Methods DESIGN/METHODS: 93 patients were enrolled in the TRAnsition Coaching for Stroke program from 9/2011-5/2012. Sociodemographic, clinical, and stroke-related data were collected before discharge. Post-discharge blood pressures were measured at clinic appointments. Participants were contacted after discharge using a script that screens for readmission risk, including questions related to blood pressure self-management.

Results RESULTS: Of 93 participants (mean age 63.9, 54.8% women, 29% non-white), 68.8% had ischemic stroke, 10.8% hemorrhagic stroke, and 19.4% TIA. Patients were categorized into 2 groups, those with adequate blood pressure control at follow up (SBP < 140, n=57 or 67.1%) and those without (SBP >140 28 or 32.9%). There was no significant difference between groups in gender, race, or age. However, those without insurance (88.2% vs 61.5% with insurance; p=0.037), less than high school education (76.5% vs 50%; 0.017), and those without diabetes (75% vs 51.75; p=0.030) were more likely to have blood pressure controlled. There were 57 patients contacted by telephone after discharge with 38 (66.7%) measuring their blood pressures at home between clinic visits. There was no difference in patients who measured pressures based on age, race, gender, education, health literacy, stroke type, risk factors, or co-morbid conditions.

Conclusions CONCLUSIONS: Although the results of this analysis was unexpected, those with no higher than high school education and without insurance might have better blood pressure control because of the individualized coaching they received without barriers to access. Lack of comparisons with patients outside of the program limits the generalizability of these results.

Authors/Disclosures
Edward L. Bradbury, MD (UW Hospital and Clinics) PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Martinson K. Arnan, MD, FAAN	Dr. Arnan has nothing to disclose.
Cheryl Bushnell, MD, MHS (Wake Forest School of Medicine)	The institution of Dr. Bushnell has received research support from PCORI. The institution of Dr. Bushnell has received research support from NIH/NINDS. Dr. Bushnell has received intellectual property interests from a discovery or technology relating to health care. Dr. Bushnell has received publishing royalties from a publication relating to health care.
Elizabeth A. Shuster, MD	No disclosure on file
Mitchell S. Elkind, MD, MS, FAAN	Dr. Elkind has received personal compensation for serving as an employee of American Heart Association. Dr. Elkind has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Atria Academy.

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