Abstract NS1: Blood Pressure Medications at Hospital Discharge

Abstract

Introduction: Recurrent strokes carry a higher risk of disability and mortality than first-ever acute ischemic stroke (AIS). Several studies have demonstrated that controlling blood pressure (BP) reduces the risk of recurrent stroke. National guidelines suggest diuretics and ACE inhibitors (ACE-i) may be preferred for BP control in stroke survivors. Hypothesis: We hypothesized that there would be a wide variation in the classes of blood pressure medications prescribed to adult AIS patients at the time of hospital discharge. Methods: We reviewed 483 consecutive adult AIS patients admitted to our institution from January 2015 to April 2017. ICH, SAH and TIA patients were excluded. BP medications were categorized by type according to the Get with the Guidelines (GWTG) database. Hypertension was defined as a known past medical history of hypertension on admission. Exploratory and descriptive analyses were performed. Results: Baseline characteristics and discharge disposition are in shown in table 1. Of the 483 AIS patients, 373 (77.2%) had a known history of hypertension. Among the patients, 335 (90%) were prescribed BP medications at discharge, 135 (40%) received an ACE-i , 69 (21%) an angiotensin receptor blocker (ARB), 121 (36%) a diuretic, 182 (54%) a beta blocker, 134 (40%) a calcium channel blocker, and 10% other BP medications. Conclusions: There is wide variation in classes of BP medications prescribed at hospital discharge after AIS. Although ACE-i and diuretics are recommended in the AHA/ASA guidelines for BP treatment after AIS, they were not prescribed to the majority of AIS patients. Further studies are needed to evaluate in-hospital antihypertensive medication prescribing patterns in a national multi-center study.