TRENDS IN ANTIHYPERTENSIVE MEDICATION USE AFTER ISCHEMIC STROKE (1999–2020)

Abstract

Objective: Hypertension (HT) is a major risk factor for stroke. The guidelines for the management of HT in stroke patients have been updated periodically and changed. We aimed to examine trends in antihypertensive medications use after ischemic stroke Design and method: Retrospective study on ischemic stroke patients discharged from 3 tertiary general hospitals, during the periods: 1999–2001, 2014–16 and 2019–2020. Data analysis was performed using SPSS statistical software (IBM SPSS Statistics 24; Chicago, IL, USA). Results: We included 1,806 patients, 753 (41.6%) women, mean age 69.7 (± 10) years. Comparing the periods, the patients are now older (68.7–69.9–71.3; p = 0.003) and have a higher frequency of HT (67.3% vs. 73.8% vs. 75.4%; p = 0.0001). HT was the most prevalent vascular risk factor in all periods. At discharge, more antihypertensive drugs were used progressively (in 56.4% vs 69.1% vs 84.7% of patients; p = 0.0001). There was a clear increase in the number of antihypertensive drugs used (mean 0.94 ± 0.8 vs 1.6 ± 1.05 vs 2.1 ± 0.5 drugs; p = 0.0001). Use of diuretics (14%-41.1%-63.8%; p = 0.0001), angiotensin-converting enzyme inhibitors (37.1%-43.8%-54%; p = 0.0001), and angiotensin receptor blockers (12.3%-24.3%-31.1%; p = 0.0001) increased progressively. On the contrary, use of calcium antagonists decreased (25%-22.5%-15.1%; p = 0.0001) Conclusions: The last 20 years has seen a significant increase in antihypertension medication use after ischemic stroke. At present, antihypertensive drugs are one of the most important medications in these patients.