Uncontrolled treated hypertension was present in 56% of young ischemic stroke survivors at 3 months and was associated with higher pulse wave velocity, BMI, and carotid plaque (all p<0.05).
Cohort (n=320)
What is the prevalence and what are the covariates of uncontrolled hypertension in young ischemic stroke survivors?
Uncontrolled hypertension is highly prevalent (56%) among young ischemic stroke survivors and is associated with obesity and arterial damage, highlighting a critical gap in secondary prevention.
PURPOSE: Hypertension is the most important modifiable risk factor for stroke. Few data are available on control of hypertension in younger ischemic stroke survivors. MATERIAL AND METHODS: We assessed clinic and ambulatory blood pressure (BP) measurements in 320 patients aged 15-60 years (mean 48 ± 10) included in the Norwegian Stroke in the Young Study during 3-months follow-up after the index stroke. Controlled hypertension was defined as ambulatory BP 1.5 mm. RESULTS: At hospital discharge, 58% of the patients were treated for hypertension. Another 9% of the total study population was diagnosed with new-onset hypertension during follow-up. At the 3-months follow-up visit, 56% of patients with treated hypertension were uncontrolled. Patients with uncontrolled treated hypertension were older, had higher body mass index (BMI) and PWV, and were more likely to have diabetes and carotid plaques compared to patients with normotension (p < .01). Compared to controlled treated hypertension, patients with uncontrolled treated hypertension had higher prevalence of carotid plaque (p < .01). In a multivariate logistic regression, uncontrolled treated hypertension was associated with higher PWV and BMI, and presence of carotid plaque, independent of the more intensified use of antihypertensive treatment (all p < .05). CONCLUSION: Uncontrolled hypertension was highly prevalent in ischemic stroke survivors <60 years and associated with co-presence of obesity and functional and structural arterial damage. Our results highlight the unmet potential and challenge of optimization of hypertension diagnosis and management in order to prevent recurrent vascular events in ischemic stroke survivors.
Oftedal et al. (Mon,) conducted a cohort in Ischemic stroke (n=320). Uncontrolled treated hypertension vs. Controlled treated hypertension or normotension was evaluated on Uncontrolled treated hypertension. Uncontrolled treated hypertension was present in 56% of young ischemic stroke survivors at 3 months and was associated with higher pulse wave velocity, BMI, and carotid plaque (all p<0.05).