title: Ambulatory treatment gaps in patients with ischemic stroke or transient ischemic attack.
abstract: BACKGROUND
  This study evaluated goal attainment for patients with a history of non-cardioembolic ischemic stroke (NCIS) or transient ischemic attack (TIA).
  
  
  METHODS
  A cross-sectional study was conducted in patients aged 18 to 85 years with a history of validated NCIS or TIA. Data collected were demographics, comorbidities, blood pressure (BP), low-density lipoprotein cholesterol (LDL-C) values, and medications within 365 days and most proximal to December 31, 2010. Goal LDL-C and BP were defined as < 100 mg/dL and < 140/90 mm Hg, respectively. Differences in sex and age (< 65 vs ≥ 65 years) were evaluated.
  
  
  RESULTS
  There were 1731 patients evaluated (mean age: 73.6 years; 58% women). Stroke type was NCIS in 51.9% and TIA in 48.1%. The LDL-C and BP were measured in 75.4% and 50.3% of patients, respectively. No difference in LDL-C screening rates existed for sex or age. Men and patients younger than age 65 years were significantly more likely to have BP measured. Overall, LDL-C and BP goals were attained by 48.9% and 43.3% of patients, respectively. Men and patients age 65 years or older were likelier than women and patients younger than age 65 years to attain LDL-C goals (p < 0.01). Men were also likelier than women to attain BP < 140/90 mm Hg (p < 0.01), but more patients younger than age 65 years vs older than age 65 years attained this goal (p < 0.01). Statins and antihypertensives were received by 51.9% and 46.9% of the patients, respectively.
  
  
  CONCLUSIONS
  Although attaining guideline-recommended goals for LDL-C and BP may present challenges, future research should focus on innovative methods to help patients attain optimal treatment goals.
authors.affiliation: Clinical Pharmacy Specialist in the Pharmacy Department for Kaiser Permanente Colorado and Clinical Associate Professor at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences in Aurora. E-mail: kari.olson@kp.org.
authors.forename: Kari L
authors.initials: KL
authors.lastname: Olson
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Lash
authors.forename: Thomas
authors.initials: T
authors.lastname: Delate
authors.forename: Michele
authors.initials: M
authors.lastname: Wood
authors.forename: Jon
authors.initials: J
authors.lastname: Rasmussen
authors.forename: Anne M
authors.initials: AM
authors.lastname: Denham
authors.forename: John A
authors.initials: JA
authors.lastname: Merenich
mesh_terms: D000367:Age Factors; D000368:Aged; D000553:Ambulatory Care; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure; D008078:Cholesterol, LDL / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D002546:Ischemic Attack, Transient / Q000097:blood / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D020521:Stroke / Q000097:blood / Q000188:drug therapy*
chemical_list: D000959:Antihypertensive Agents; D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents