Literature DB >> 15118825

[Factors influencing secondary preventive blood pressure control in hypertensive stroke patients].

K Spengos1, G Tsivgoulis, E Manios, N Zakopoulos, V Zis, K Vemmos.   

Abstract

BACKGROUND: More than half of patients with documented hypertension surviving cerebrovascular events do not have their blood pressure (BP) controlled, despite the use of antihypertensive medication. Data on the possible reasons for poor BP control in stroke survivors are limited.
METHODS: We evaluated prospectively parameters influencing the effectiveness of BP control in hypertensive stroke survivors who were followed up.
RESULTS: At 3 months after stroke BP was effectively controlled in only 38.8% of patients. Diabetes mellitus had a negative influence on the effectiveness of antihypertensive medication by reducing significantly the chance of achieving a significant BP reduction, while patients suffering from coronary artery disease had an increased chance of getting their BP under control within 3 months after stroke onset. Diuretic medication was found to be an independent positive predictor for effective antihypertensive control. Combined therapy including diuretics was significantly more effective than antihypertensive monotherapy.
CONCLUSIONS: Arterial pressure control in stroke survivors is poor. Risk factor profile, manifest heart disease, and the chosen antihypertensive medication are factors of prognostic relevance for effective BP control.

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Year:  2005        PMID: 15118825     DOI: 10.1007/s00115-004-1721-8

Source DB:  PubMed          Journal:  Nervenarzt        ISSN: 0028-2804            Impact factor:   1.214


  14 in total

1.  1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension. Guidelines Subcommittee.

Authors: 
Journal:  J Hypertens       Date:  1999-02       Impact factor: 4.844

2.  Cardiovascular protection and blood pressure reduction: a meta-analysis.

Authors:  J A Staessen; J G Wang; L Thijs
Journal:  Lancet       Date:  2001-10-20       Impact factor: 79.321

3.  Ineffective secondary prevention in survivors of cardiovascular events in the US population: report from the Third National Health and Nutrition Examination Survey.

Authors:  A I Qureshi; M F Suri; L R Guterman; L N Hopkins
Journal:  Arch Intern Med       Date:  2001-07-09

4.  Potential adverse effects of blood pressure lowering--J-curve revisited.

Authors:  J A Staessen
Journal:  Lancet       Date:  1996-09-14       Impact factor: 79.321

5.  The Athens stroke registry: results of a five-year hospital-based study.

Authors:  K N Vemmos; C E Takis; K Georgilis; N A Zakopoulos; J P Lekakis; C M Papamichael; V P Zis; S Stamatelopoulos
Journal:  Cerebrovasc Dis       Date:  2000 Mar-Apr       Impact factor: 2.762

6.  Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).

Authors: 
Journal:  JAMA       Date:  2002-12-18       Impact factor: 56.272

7.  Prognosis of stroke in the south of Greece: 1 year mortality, functional outcome and its determinants: the Arcadia Stroke Registry.

Authors:  K N Vemmos; M L Bots; P K Tsibouris; V P Zis; C E Takis; D E Grobbee; S Stamatelopoulos
Journal:  J Neurol Neurosurg Psychiatry       Date:  2000-11       Impact factor: 10.154

Review 8.  Insulin and the vasculature--old actors, new roles.

Authors:  A D Baron
Journal:  J Investig Med       Date:  1996-10       Impact factor: 2.895

9.  Hypertension in Diabetes Study (HDS): I. Prevalence of hypertension in newly presenting type 2 diabetic patients and the association with risk factors for cardiovascular and diabetic complications.

Authors: 
Journal:  J Hypertens       Date:  1993-03       Impact factor: 4.844

10.  Blood pressure after stroke. A one-year follow-up study.

Authors:  A Carlsson; M Britton
Journal:  Stroke       Date:  1993-02       Impact factor: 7.914

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