Premorbid Blood Pressure Control Of Incident Transient Ischaemic Attacks And Strokes; Prevalence And Determinants; Analysis Of Individual Patient Data Over 10 Years

Background: Uncontrolled blood pressure is the most important modifiable risk factor for strokes. Aims and Methods: We determined the prevalence and determinants of blood pressure control in patients with incident transient ischaemic attacks(TIA) and strokes from 2002-2012 in a population-based cohort(Oxford Vascular Study). Controlled blood pressure(BP) was defined as having BP Results: Among 1741 patients with incident TIA/strokes, 1051 (60.4%) had known hypertension, of which 891 (84.8%) were on anti-hypertensive treatment. However, only 698 (40.1%) of all and 306 (29.1%) of treated patients had controlled BP. On predicted 10-year CV-Risk at event, 861 (72.5%) of 1188 (77.0%) in high risk group had known hypertension, of which 758 (88.0%) were on treatment. However, only 346 (29.1%) of all in high-risk group and 190 (25.1%) of treated high risk patients had controlled BP. In contrast, 120 (88.2%) of 136 (8.8%) in low risk group had controlled BP. Risk stratification without scoring for BP showed consistent results except the number in high-risk group dropped to 863 (55.9%). Analysis with CV-risk 10years pre-event also showed similar trends. Age(adjusted OR=0.97, 95%CI=0.97-0.98, p 2; 1.54, 1.15-2.06, p Conclusions: Premorbid blood pressure control in patients with incident TIA/strokes was inadequate especially in high-risk patients. Controlling BP to targets in elderly and high CV-risk patients would be important in reducing incident TIA/strokes.