Blood pressure control among stroke patients in Thailand--the i-STROKE study

Autor: Samart, Nidhinandana, Disya, Ratanakorn, Nijasri, Charnnarong, Sombat, Muengtaweepongsa, Somchai, Towanabut, Patinun, Chirawatthanaphan
Rok vydání: 2013
Předmět:
Male
medicine.medical_specialty
Health Knowledge
Attitudes
Practice
Time Factors
Cross-sectional study
Blood Pressure
Drug Utilization Review
Patient Education as Topic
Risk Factors
Internal medicine
Diabetes mellitus
Odds Ratio
Medicine
Humans
Practice Patterns
Physicians'
Stroke
Antihypertensive Agents
Aged
Retrospective Studies
Chi-Square Distribution
business.industry
Incidence (epidemiology)
Incidence
Rehabilitation
Retrospective cohort study
Odds ratio
Awareness
Middle Aged
medicine.disease
Thailand
Patient Discharge
Blood pressure
Cross-Sectional Studies
Logistic Models
Treatment Outcome
Hypertension
Multivariate Analysis
Practice Guidelines as Topic
Physical therapy
Surgery
Observational study
Female
Neurology (clinical)
Guideline Adherence
Cardiology and Cardiovascular Medicine
business
Zdroj: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 23(3)
ISSN: 1532-8511
Popis: Background Direct correlation between stroke mortality and hypertension calls for a tight blood pressure (BP) control. Our study determined the prevalence of the BP control and evaluated current clinical practices on hypertension management in stroke patients in Thailand. Methods This multicenter, cross-sectional, retrospective, observational study was carried out between February 2010 and January 2011 and enrolled stroke patients aged 45 years or older with ictus incidence 12,030 days before the enrollment. The events were confirmed by either computerized tomography scan or magnetic resonance imaging. Patient data including demographics, medical, and clinical history were collected. Results At enrollment, 274 of 558 (49.1%) patients had controlled arterial BP with an average pressure of 134.220.4/78.812.8 mm Hg; 412 (73.8%) patients received antihypertensive medications and the most common use was angiotensin-converting enzyme inhibitors (ACEIs), reported in 200 (35.8%) patients. With questionnaire, insufficient antihypertensive use and lack of patients' awareness were the 2 most common reasons given by physicians for the patients' uncontrolled BP. Factors identified to have adverse association with the controlled BP at enrollment were diabetes at baseline, stage II hypertension, stage I hypertension, and the use of ACEIs at discharge (odds ratio of .18, .24, .30 [ P P = .009], respectively). Conclusions Despite clinical evidence of the benefits of the BP control in reduction of secondary stroke events, a substantial number of stroke patients in Thailand do not achieve their BP targets, and this could possibly be a result of inadequate use of antihypertensive therapies and lack of compliance to BP management guidelines.
Databáze: OpenAIRE
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