Blood Pressure Control From 2011 To 2019 In Patients 90 Days After Stroke

Background and Aims Whether and how much stroke survivors’ blood pressure (BP) control changed over the 2010s decade is unclear. We assessed whether 90-day BP control changed from 2011 to 2019, and whether temporal changes varied by ethnicity and sex. Methods We conducted a prospective cohort study of 1,755 first expert-adjudicated stroke cases ≥45 years in the Brain Attack Surveillance in Corpus Christi (BASIC) project with BP measurements from 2011-2019. We measured BP in patients’ residences at ∼90 days post-stroke using standardized procedures and validated oscillometric devices. The average of three BP measurements was used. Outcomes were BP control <130/80 mmHg (primary) and BP control<140/90 mmHg (secondary). We used inverse probability weights to account for attrition due to 90-day mortality and non-participation in study interviews. Using logistic regression, we examined the association between BP control and time (year) and demographic differences in trends through interactions with time adjusting for patient factors. Results Median age was 66 years (interquartile range, 58-76 years), 59% were Mexican American, 49% were women. From 2011 to 2019, BP control <130/80 mmHg declined from 43.0% to 28.6% (P<0.001). Odds of BP control <130/80 mmHg decreased over time (odds ratio per one-year increase, 0.95; 95% CI, 0.91, 0.99) after adjustment for patient factors. BP control <140/90 mm Hg remained consistent at 59.3% in 2011 and 57.1% in 2019 (P=0.31). Odds of BP control <140/90 mm Hg appeared constant over time after adjustment for patient factors (odds ratio per one-year increase, 1.00; 95% CI, 0.96, 1.04). Trends in BP control <130/80 mmHg and <140/90 mmHg did not significantly differ by ethnicity or sex. Conclusions From 2011 to 2019, BP control <130/80 mmHg decreased and BP control <140/90 mmHg did not improve in patients 90 days after stroke. Results suggest stroke survivors need effective, sustainable strategies to achieve BP control. AHA Journals Subject Terms Cerebrovascular Disease/Stroke, Blood Pressure, Quality and Outcomes, Health Services