Poor long-term blood pressure control after intracerebral hemorrhage.
Poor long-term blood pressure control after intracerebral hemorrhage.
Available online from MWHC library: 1970 - present, Available in print through MWHC library: 1999 - 2006
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. 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. 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).
English
0039-2499
*African Continental Ancestry Group/eh [Ethnology]
*Blood Pressure/ph [Physiology]
*Cerebral Hemorrhage/eh [Ethnology]
*Cerebral Hemorrhage/pp [Physiopathology]
*European Continental Ancestry Group/eh [Ethnology]
*Hypertension/eh [Ethnology]
*Hypertension/pc [Prevention & Control]
Antihypertensive Agents/tu [Therapeutic Use]
Cohort Studies
Environment
Female
Follow-Up Studies
Humans
Hypertension/pp [Physiopathology]
Linear Models
Longitudinal Studies
Male
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Prospective Studies
Social Support
Time Factors
Treatment Outcome
MedStar Health Research Institute
MedStar Heart & Vascular Institute
MedStar Washington Hospital Center
Neurology
Comparative Study
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Available online from MWHC library: 1970 - present, Available in print through MWHC library: 1999 - 2006
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. 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. 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).
English
0039-2499
*African Continental Ancestry Group/eh [Ethnology]
*Blood Pressure/ph [Physiology]
*Cerebral Hemorrhage/eh [Ethnology]
*Cerebral Hemorrhage/pp [Physiopathology]
*European Continental Ancestry Group/eh [Ethnology]
*Hypertension/eh [Ethnology]
*Hypertension/pc [Prevention & Control]
Antihypertensive Agents/tu [Therapeutic Use]
Cohort Studies
Environment
Female
Follow-Up Studies
Humans
Hypertension/pp [Physiopathology]
Linear Models
Longitudinal Studies
Male
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Prospective Studies
Social Support
Time Factors
Treatment Outcome
MedStar Health Research Institute
MedStar Heart & Vascular Institute
MedStar Washington Hospital Center
Neurology
Comparative Study
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural