Document Detail


Poor long-term blood pressure control after intracerebral hemorrhage.
MedLine Citation:
PMID:  22903494     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Hypertension is the most important risk factor associated with intracerebral hemorrhage. We explored racial differences in blood pressure (BP) control after intracerebral hemorrhage and assessed predictors of BP control at presentation, 30 days, and 1 year in a prospective cohort study.
METHODS: Subjects with spontaneous intracerebral hemorrhage were identified from the DiffErenCes in the Imaging of Primary Hemorrhage based on Ethnicity or Race (DECIPHER) Project. BP was compared by race at each time point. Multivariable linear regression was used to determine predictors of presenting mean arterial pressure, and longitudinal linear regression was used to assess predictors of mean arterial pressure at follow-up.
RESULTS: A total of 162 patients were included (mean age, 59 years; 53% male; 77% black). Mean arterial pressure at presentation was 9.6 mm Hg higher in blacks than whites despite adjustment for confounders (P=0.065). Fewer than 20% of patients had normal BP (<120/80 mm Hg) at 30 days or 1 year. Although there was no difference at 30 days (P=0.331), blacks were more likely than whites to have Stage I/II hypertension at 1 year (P=0.036). Factors associated with lower mean arterial pressure at follow-up in multivariable analysis were being married at baseline (P=0.032) and living in a facility (versus personal residence) at the time of BP measurement (P=0.023).
CONCLUSIONS: Long-term BP control is inadequate in patients after intracerebral hemorrhage, particularly in blacks. Further studies are needed to understand the role of social support and barriers to control to identify optimal approaches to improve BP in this high-risk population.
Authors:
Darin B Zahuranec; Jeffrey J Wing; Dorothy F Edwards; Ravi S Menon; Stephen J Fernandez; Richard E Burgess; Ian A Sobotka; Laura German; Anna J Trouth; Nawar M Shara; M Chris Gibbons; Bernadette Boden-Albala; Chelsea S Kidwell
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural     Date:  2012-08-16
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  43     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-25     Completed Date:  2013-01-17     Revised Date:  2013-10-17    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2580-5     Citation Subset:  IM    
Affiliation:
Department of Neurology, Stroke Program, School of Public Health, University of Michigan Cardiovascular Center, Ann Arbor, MI 48109-5855, USA. zdarin@umich.edu
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MeSH Terms
Descriptor/Qualifier:
African Continental Ancestry Group / ethnology*
Antihypertensive Agents / therapeutic use
Blood Pressure / physiology*
Cerebral Hemorrhage / ethnology*,  physiopathology*
Cohort Studies
Environment
European Continental Ancestry Group / ethnology*
Female
Follow-Up Studies
Humans
Hypertension / ethnology*,  physiopathology,  prevention & control*
Linear Models
Longitudinal Studies
Male
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Prospective Studies
Social Support
Time Factors
Treatment Outcome
Grant Support
ID/Acronym/Agency:
K23 AG038731/AG/NIA NIH HHS; K23AG038731/AG/NIA NIH HHS; U54 NS057405/NS/NINDS NIH HHS; U54NS057405/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Antihypertensive Agents
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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