Lowering blood pressure after stroke

Reported by Susan Aldridge, PhD, medical journalist

A study suggests that guidelines on lowering blood pressure after a stroke might not be relevant to patients in primary care.
When someone has had a stroke it is important that they get their blood pressure under control - usually by a combination of medication and lifestyle measures. The guidelines relating to this come from a big clinical trial called PROGRESS which recruited people with stroke from hospitals.

Researchers at the University of Birmingham are now wondering if these guidelines are actually applicable to patients in primary care. They compared the characteristics of stroke patients from seven general practices in Birmingham with those of the participants in the PROGRESS trial. The general practice group tended to be, on average, about 12 years older than those in the PROGRESS group. They were also twice as likely to be women. The time that had elapsed since their stroke was more like two to three years, compared to eight months.

For 61 per cent of the patients, systolic (top figure) blood pressure was above the target recommended in UK guidelines and for 77 per cent it was over the target set by the British Hypertension Society. Therefore, the typical stroke patient in primary care probably needs some fresh guidelines for blood pressure control.

Source
BMJ Online First 23rd February 2006