title: Treatment goals for ambulatory blood pressure and plasma lipids after stroke are often not reached.
abstract: BACKGROUND
  In Danish health care, secondary prevention after stroke is currently handled mainly by general practitioners using office blood pressure (OBP) assessment of hypertension. The aim of this study was to compare the OBP approach to 24-hour assessment by ambulatory blood pressure (ABP) monitoring. Furthermore, we aimed to record the degree of adherence to recommended therapy goals for blood pressure and plasma lipids.
  
  
  METHODS
  In a prospective observational study, 45 stroke patients aged 25-64 years who were participating in specialized intensive outpatient rehabilitation were monitored by OBP and ABP on average 1.3 (0.14-4.3) years post stroke. Furthermore, data on additional risk factors and medication for secondary prevention were collected.
  
  
  RESULTS
  OBP and daytime ABP exceeded the therapy goal of 130/80 mmHg in 71% and 44% of the patients, respectively. ABP exceeded the night-time therapy goal of 115/65 in 57% of cases. Normal dipping at night was found in only 41% (systolic) and 32% (diastolic) of the patients. Considering both day- and night-time blood pressure, antihypertensive medication was absent or inadequate in 60%. Low density lipid (LDL) levels exceeded the recommended limit of 2.5 mmol/l in 49%.
  
  
  CONCLUSIONS
  For blood pressure (BP) and cholesterol, secondary prevention is far from ideal in post-stroke patients. Compared with OBP, ABP demands more resources, but in turn yields more reliable results and also provides important information about diurnal BP variation. ABP monitoring at least once after stroke should therefore be implemented routinely.
  
  
  BACKGROUND
  Aase og Einar Danielsens Fond.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: Center for Hjerneskade, Amagerfælledvej 56A, 2300 København S, Denmark. aae@dadlnet.dk
authors.forename: Aase Worsaa
authors.initials: AW
authors.lastname: Engberg
authors.forename: Klaus
authors.initials: K
authors.lastname: Kofoed
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D011446:Prospective Studies; D055502:Secondary Prevention; D020521:Stroke / Q000097:blood / Q000517:prevention & control*; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
chemical_list: D000959:Antihypertensive Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides