What question did this study set out to answer?

This study aims to examine the impact of medical and non-medical factors on the prescribing of antihypertensives at discharge for patients with elevated blood pressure after stroke.

February 2, 2026

Abstract WP313: Influence of Medical and Non-Medical Risk Factors on Discharge Medication Prescribing Antihypertensives After Stroke: Analysis on a Diverse Cohort

Q: What does this research mean for the field?

Among patients with hypertension after stroke, older age and Black race are linked to a higher likelihood and number of antihypertensives prescribed. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

Key Result

Among patients with hypertension after stroke, older age (OR 1.03) and Black race (OR 2.00) were linked to higher likelihood and number of antihypertensives prescribed.

Key Points

This study aims to examine the impact of medical and non-medical factors on the prescribing of antihypertensives at discharge for patients with elevated blood pressure after stroke.
Analyzed data from 540 patients with ischemic stroke, hemorrhagic stroke, or TIA from the VIRTUAL trial.
Used logistic and ordinal regression to assess associations between demographics, insurance, and vascular risk factors with antihypertensive prescribing.
Subgroup analysis focused on patients with established hypertension.
87% of patients with hypertension received at least one antihypertensive at discharge.
Older age and hypertension diagnosis significantly associated with prescribing.
Among those with hypertension, older age and Black race correlated with higher medication counts.
Average discharge systolic blood pressure was higher in those prescribed antihypertensives compared to those not prescribed.

Structured PICO

What medical and non-medical factors are associated with antihypertensive prescribing at discharge in patients with stroke or TIA and elevated blood pressure?

Population

540 patients with ischemic stroke, hemorrhagic stroke, or TIA with prior hypertension or elevated BP during hospitalization, median age 63, 47% female.

Outcome

Any antihypertensive prescription at discharge

Older age and Black race are associated with a higher likelihood and number of antihypertensives prescribed at discharge after stroke, while insurance status did not explain prescribing differences.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Introduction: Guideline-directed secondary prevention is critical to reduce recurrent stroke and cardiovascular events, including the prescription of antihypertensive medications at discharge for those with elevated blood pressure (BP). However, disparities in BP control after stroke persist. Non-medical factors such as insurance, demographics, and vascular risk may influence prescribing, yet their impact is not well defined. Identifying gaps in care early after stroke can guide interventions to reduce inequities. This study examined medical and non-medical factors associated with antihypertensive prescribing in patients with elevated BP during stroke hospitalization. Methods: We analyzed 540 patients with ischemic stroke, hemorrhagic stroke, or TIA enrolled in the VIRTUAL trial (March 2022–April 2025). The trial includes patients with prior hypertension or elevated BP during hospitalization in a 6-month telehealth intervention for BP control. Logistic and ordinal regression assessed associations between age, sex, race/ethnicity, insurance, hypertension, and vascular risk factors with (1) any antihypertensive prescription and (2) number of medications. Subgroup analysis was conducted among those with established hypertension. Results: Of 540 patients, 47% were female, median age 63, 22% uninsured, 31.5% Hispanic, 35.4% Non-Hispanic Black, and 30.7% Non-Hispanic White (Table 1). Among patients with hypertension, 87% received ≥1 antihypertensive at discharge. In adjusted analysis, older age (OR 1.03; 95% CI 1.01–1.05) and hypertension diagnosis (OR 17.71; 95% CI 3.78–129.21) were associated with prescribing. Among those with established hypertension, older age (OR 1.02; 95% CI 1.004–1.03) and Black race (OR 2.00; 95% CI 1.34–2.99) were linked to higher medication counts (Table 2). Despite treatment, average systolic BP at discharge remained higher in those prescribed medication (145.3 mmHg) compared to those not prescribed (136.8 mmHg). Conclusion: In this diverse stroke cohort, older age and Black race were linked to both likelihood and number of antihypertensives prescribed, suggesting under-prescribing in younger patients or greater treatment needs in older and Black individuals. Similar patterns observed for Black patients may indicate differences in prescribing or treatment resistance. Insurance status did not explain prescribing differences. Further research is needed to clarify prescribing practices and the trajectory of blood pressure control after stroke.