Antihypertensive medication usage during stroke rehabilitation: the Post-Stroke Rehabilitation Outcomes Project (PSROP).
Blood pressure management is an important issue for the primary prevention, acute management, and secondary prevention of a stroke. Rehabilitation professionals need to consider the timing in lowering blood pressures in stroke survivors, the types of medications that should be used in managing hypertension, and the target pressures to achieve. The Post-Stroke Rehabilitation Outcomes Project (PSROP) database was used to describe the types of antihypertensive medications prescribed to stroke survivors, compare prescription patterns with current practice guidelines of the management of hypertension after a stroke, and determine whether systolic and diastolic blood pressures decrease during admissions to inpatient rehabilitation facilities (IRFs). Of the 1,161 patients in the PSROP database, the most commonly prescribed antihypertensive medications were the angiotensin-converting enzyme antagonists and angiotensin II antagonists, followed by beta-blockers, calcium-channel blockers and diuretics, adrenergics (alpha-blockers), and other (minoxidil, hydralazine) medications. Systolic, diastolic, and mean arterial pressures declined in participants during admissions to IRFs. However, blood pressures were significantly higher throughout IRF stays in participants receiving antihypertensive medications when compared to those not receiving antihypertensive medications. Rehabilitation professionals need to be cognizant of the relationship between stroke and hypertension, clinical practice guidelines that provide evidence-based management tools for hypertension, and patient issues that may hinder the effective treatment of hypertension.
Zorowitz
Richard D
RD
Physical Medicine and Rehabilitation, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
Smout
Randall J
RJ
Gassaway
Julie A
JA
Horn
Susan D
SD
D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001795:Blood Pressure Determination; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004363:Drug Utilization; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012042:Registries; D018570:Risk Assessment; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis / Q000401:mortality; D000071939:Stroke Rehabilitation; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States
D000959:Antihypertensive Agents