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[Antihypertensive treatment preceding cerebrovascular diseases is insufficient according to recommendations]
Aneta Aleksandra Nielsen1, Cramer Christensen, Ivan Brandslund
1Klinisk Biokemisk Afdeling, Vejle Sygehus, DK-7100 Vejle. Aneta.Aleksandra.Nielsen@vgs.regionsyddanmark.dk
Insights
High blood pressure is common in patients experiencing cerebrovascular events. Current hypertension management is inadequate, indicating a need for better detection and treatment to prevent strokes.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Public Health
Context:
- Hypertension, diabetes, and age are established risk factors for cerebrovascular events.
- Evaluating adherence to treatment recommendations and achievement of blood pressure goals in patients with cerebrovascular events is crucial.
Purpose:
- To investigate the prevalence of hypertension, diabetes, and antihypertensive treatment in patients admitted for cerebrovascular events.
- To assess whether current clinical recommendations and treatment targets for hypertension are being met.
Summary:
- A study of 253 patients admitted for cerebrovascular events revealed that 74% had elevated pre-admission blood pressure.
- Despite this, 59% were on antihypertensive treatment, and 80% of those treated still had blood pressure above 140/90 mmHg.
- A significant portion (41%) received no antihypertensive treatment, even with elevated blood pressure.
Impact:
- Findings indicate unsatisfactory management of hypertension, suggesting many cerebrovascular events could be preventable.
- Improved detection of undiagnosed hypertension and more aggressive antihypertensive treatment are recommended to reduce event incidence.
Introduction:
Hypertension, diabetes mellitus and age are risk factors for cerebrovascular events. The aim of this study was to investigate the presence of hypertension, diabetes and antihypertensive treatment preceding disease debut in patients admitted to hospital with cerebrovascular events in order to evaluate if recommendations are followed and treatment goals are achieved.
Materials And Methods:
A total of 351 patients were admitted to hospital due to cerebrovascular events during a three-month period in Vejle County. The study included the 253 (72%) of 351 patients whose blood pressure had been measured within the five year period preceeding hospitalisation. Patient data and information about medication before the cerebrovascular events were obtained from the hospital's electronic database and the health care system of Vejle County. Patients were divided into four groups: intracerebral haemorrhage, cerebral infarction, stroke and transient cerebral ischaemia.
Results:
The median patient age was 74 years with no gender difference. Diabetes was present in 13% of patients. A total of 74% of all patients had a pre-admission blood pressure that was too high, 59% were being treated with antihypertensives and 80% had blood pressure >/= 140/90. The remaining 41% of all patients received no antihypertensive treatment, though 66% had elevated blood pressure.
Conclusions:
A total of 74% of all patients had increased blood pressure before hospital admittance. Our study shows that management of hypertension is unsatisfactory, and many cerebrovascular events may be prevented through improved detection of unknown hypertension and more intensive anti-hypertensive treatment.
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