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Doogue, Róisín; McCann, David; Fitzgerald, Noirin; Murphy, Andrew W.; Glynn, Liam G.; Hayes, Peter

Blood pressure control in patients with a previous stroke/transient ischaemic attack in primary care in Ireland: a cross sectional study

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  • Medientyp: E-Artikel
  • Titel: Blood pressure control in patients with a previous stroke/transient ischaemic attack in primary care in Ireland: a cross sectional study
  • Beteiligte: Doogue, Róisín; McCann, David; Fitzgerald, Noirin; Murphy, Andrew W.; Glynn, Liam G.; Hayes, Peter
  • Erschienen: Springer Science and Business Media LLC, 2020
  • Erschienen in: BMC Family Practice
  • Sprache: Englisch
  • DOI: 10.1186/s12875-020-01211-z
  • ISSN: 1471-2296
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Uncontrolled blood pressure (BP) is an important modifiable risk factor for recurrent stroke. Secondary prevention measures when implemented can reduce stroke re-occurrence by 80%. However, hypertension control rates remain sub-optimal, and little data is available from primary care where most management occurs.</jats:p> <jats:p>The aim of this study was to describe BP control in primary care-based patients with a previous stroke or transient ischaemic attack (TIA) in Ireland, and to concurrently examine antihypertensive medication-dosing.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Study participants most recent office-based BP reading was compared with the NICE (NG136) and European Society of Hypertension/ European Society of Cardiology (ESH/ESC 2013) goal of BP &lt; 140/90 mmHg. Optimal anti-hypertensive medication dosing was determined by benchmarking prescribed doses for each drug with the World Health Organisation-Defined Daily Dosing (WHO-DDD) recommendations.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>We identified 328 patients with a previous stroke or TIA in 10 practices. Blood pressure was controlled in almost two thirds of patients when measured against the ESH/ESC and NICE guidelines (63.1%, <jats:italic>n</jats:italic> = 207). Of those with BP ≥140/90 (<jats:italic>n</jats:italic> = 116), just under half (<jats:italic>n</jats:italic> = 44, 47.3%) were adequately dosed in all anti-hypertensive medications when compared with the WHO-DDD recommendations.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Blood pressure control in patients post stroke/TIA appears sub-optimal in over one third of patients. A comparison of drug doses with WHO-DDD recommendations suggests that 47% of patients may benefit from drug-dose improvements. Further work is required to assess how best to manage blood pressure in patients with a previous stroke or TIA in Primary Care, as most consultations for hypertension take place in this setting.</jats:p> </jats:sec>
  • Zugangsstatus: Freier Zugang