Comparison of Hypertension Management After Stroke and Myocardial Infarction: Results from ECLAT1--a French Nationwide Study

Background And Purpose: Hypertension control is a cornerstone of preventive treatment in patients at risk for cerebral attack. The aim of this study was to analyze hypertension management in secondary prevention of stroke as compared with patients in secondary prevention of myocardial infarction (MI).

Methods: The ECLAT1 study was a cross-sectional study conducted in all French regions in a random sample of 3009 practitioners. Patients with a documented history of atherothrombotic disease were included. Risk factors and the last measurement of blood pressure (BP) available in the medical record were noted. In the current study, patients with treated hypertension and a unique manifestation of atherothrombotic disease, ischemic stroke or MI, were analyzed.

Results: Among the 4346 patients included in the ECLAT1 study, 1416 patients with treated hypertension and stroke or MI were analyzed. Hypertension control was poorer in patients with stroke as compared with patients with MI (24.56% versus 34.16% P<0.01). Compared with patients with MI, systolic BP (140.61+/-14.14 versus 144.21+/-14.99; P<0.0001), pulse pressure (59.91+/-11.94 versus 62.48+/-12.49; P<0.001), and, to a lesser extent, diastolic BP (80.69+/-8.39 versus 81.72+/-8.85; P<0.05) were higher in stroke patients. Moreover, antihypertensive monotherapy was more frequently used in stroke than in MI patients (43.16% versus 31.44% P<0.0001).

Conclusions: With respect to the beneficial influence of tight BP control in secondary prevention of stroke, our results highlight the need for information provided to practitioners to recall the importance of hypertension control in this situation and to increase the use of combination therapy.