Stroke prevention 2003: are we any closer to adequate blood pressure control?

Abstract

Background: Hypertension (HTN) remains the strongest modifiable risk factor for stroke. The objective of this study was to assess the utility of a Stroke Screening Tool (SST) for detection of HTN at Community Education Fairs (CEF). Methods: Three RNs gave the SST to volunteer participants (VP) at CEF in Southeastern Wisconsin from 2002–2003. SST included assessment of BP and past medical and family history (HX). BP was divided into groups according to the JNC 7 guidelines. Demographic data, BP, frequency, and means were reported. Results: One hundred thirty-one VP with mean age of 52.5 ± 1.4 (mean ± SE) were included. Seventy-five percent were females, 20% were African Americans, and 63% had a self-reported history of HTN (SRHH). Using SST, 39% fulfilled the JNC-7 HTN criteria. The probability of detecting HTN was 64%. Mean systolic blood pressure (SBP) of VP with SRHH was significantly higher (143.2 ± 2.6 v 129.2 ± 1.9) than VP without SRHH. No difference in diastolic BP was found. Of VP with SBP > 160 mm Hg, 69% had SRHH and 31% did not report HX of HTN. Those with SRHH, 63% had SBP > 140 mm Hg. In VP without SRHH, 25% had HTN. Conclusion: HTN and PMH screening in CEF remains a useful method to assess stroke risk factors. However, this study suggests that VP with HX of HTN are poorly treated despite educational efforts. Prevention programs should emphasize current BP guidelines and the importance of adequate BP control.