BACKGROUND AND PURPOSE: The majority of stroke fatalities occur in elderly women. We compared prescribing and adherence to antihypertensive therapies shown to reduce fatal and nonfatal stroke recurrence among elderly women and men with acute stroke. METHODS: Using the Registry of the Canadian Stroke Network, we identified all patients >or=66 years of age discharged home from 11 tertiary care centers with acute stroke (July 1, 2003, through March 31, 2006) in Ontario, Canada. Stroke cases were linked to the Ontario Drug Benefits Database and evaluated for prescription claims for thiazide diuretic, angiotensin converting enzyme inhibitor, beta blocker, angiotensin receptor blocker, or calcium channel blocker within 1 year of discharge from hospital. One-year adherence was assessed using the proportion of days covered with suboptimal adherence defined as a proportion of days covered <0.8. RESULTS: A total of 3571 patients (51.6% women) >or=66 years of age with acute stroke were discharged home, with 87.6% of women and 84.7% of men treated with antihypertensive therapy within 1 year of stroke. Men were more likely than women to be prescribed angiotensin converting enzyme inhibitor monotherapy but just as likely to be prescribed angiotensin converting enzyme inhibitor/diuretic combination. Women were more likely to be prescribed all other classes of antihypertensive therapy. Suboptimal adherence occurred in 32% of patients receiving thiazide diuretics, 25% for angiotensin converting enzyme inhibitors, and 38% for angiotensin converting enzyme inhibitor/diuretic combination. There were no sex differences in adherence to these antihypertensive therapies. Patients who died after stroke had lower adherence to antihypertensive therapy compared with those who survived. CONCLUSIONS: In a cohort of elderly stroke patients, women were generally just as likely or more likely than men to receive antihypertensive prescriptions after stroke. Drug adherence was similarly poor in women and men.
BACKGROUND AND PURPOSE: The majority of stroke fatalities occur in elderly women. We compared prescribing and adherence to antihypertensive therapies shown to reduce fatal and nonfatal stroke recurrence among elderly women and men with acute stroke. METHODS: Using the Registry of the Canadian Stroke Network, we identified all patients >or=66 years of age discharged home from 11 tertiary care centers with acute stroke (July 1, 2003, through March 31, 2006) in Ontario, Canada. Stroke cases were linked to the Ontario Drug Benefits Database and evaluated for prescription claims for thiazide diuretic, angiotensin converting enzyme inhibitor, beta blocker, angiotensin receptor blocker, or calcium channel blocker within 1 year of discharge from hospital. One-year adherence was assessed using the proportion of days covered with suboptimal adherence defined as a proportion of days covered <0.8. RESULTS: A total of 3571 patients (51.6% women) >or=66 years of age with acute stroke were discharged home, with 87.6% of women and 84.7% of men treated with antihypertensive therapy within 1 year of stroke. Men were more likely than women to be prescribed angiotensin converting enzyme inhibitor monotherapy but just as likely to be prescribed angiotensin converting enzyme inhibitor/diuretic combination. Women were more likely to be prescribed all other classes of antihypertensive therapy. Suboptimal adherence occurred in 32% of patients receiving thiazide diuretics, 25% for angiotensin converting enzyme inhibitors, and 38% for angiotensin converting enzyme inhibitor/diuretic combination. There were no sex differences in adherence to these antihypertensive therapies. Patients who died after stroke had lower adherence to antihypertensive therapy compared with those who survived. CONCLUSIONS: In a cohort of elderly strokepatients, women were generally just as likely or more likely than men to receive antihypertensive prescriptions after stroke. Drug adherence was similarly poor in women and men.
Authors: Deborah A Levine; Lewis B Morgenstern; Kenneth M Langa; John D Piette; Mary A M Rogers; Sudeep J Karve Journal: Ann Neurol Date: 2013-02-22 Impact factor: 10.422
Authors: Rebecca J Lank; Lynda D Lisabeth; Deborah A Levine; Darin B Zahuranec; Kevin A Kerber; Fatema Shafie-Khorassani; Erin Case; Belinda G Zuniga; George M Cooper; Devin L Brown; Lewis B Morgenstern Journal: Stroke Date: 2019-05-14 Impact factor: 7.914
Authors: Teresa M Damush; Laura Myers; Jane A Anderson; Zhangsheng Yu; Susan Ofner; Gloria Nicholas; Barbara Kimmel; Arlene A Schmid; Thomas Kent; Linda S Williams Journal: Transl Behav Med Date: 2016-09 Impact factor: 3.046
Authors: Ian M Kronish; Michael A Diefenbach; Donald E Edmondson; L Alison Phillips; Kezhen Fei; Carol R Horowitz Journal: J Gen Intern Med Date: 2013-01-04 Impact factor: 5.128
Authors: Sinéad M Langan; Sigrún A J Schmidt; Kevin Wing; Vera Ehrenstein; Stuart G Nicholls; Kristian B Filion; Olaf Klungel; Irene Petersen; Henrik T Sørensen; William G Dixon; Astrid Guttmann; Katie Harron; Lars G Hemkens; David Moher; Sebastian Schneeweiss; Liam Smeeth; Miriam Sturkenboom; Erik von Elm; Shirley V Wang; Eric I Benchimol Journal: CMAJ Date: 2019-06-24 Impact factor: 8.262