Hypertension associated with functional status early after hospitalization for ischemic stroke: A cohort study

Abstract Background Permissive hypertension in the hyperacute phase of acute ischemic stroke (AIS) is an accepted standard of care; optimal strategies for hypertension management among patients in the post-acute care phase are unknown. This study aimed to identify the association of hypertension management on functional outcomes during the post-acute care phase. Methods This retrospective cohort study at a comprehensive stroke center included adults age ≥ 18 with a primary diagnosis of AIS who were discharged to home or an inpatient rehabilitation facility (IRF). The primary outcome was functional improvement defined as an increase of modified Rankin Scale (mRS) by 1 or more point between discharge and follow-up. Univariate analyses with the Chi-square test and t-test assessed differences between baseline characteristics between the home and IRF groups. Covariates and functional improvement associations were assessed with multivariable logistic regression. Results Patients with hypertension discharged to IRF had a higher odds of no functional improvement between hospital discharge and clinic follow-up (OR 2.53, 95% CI: 1.02-6.59) compared to those without hypertension. Patients discharged to IRF prescribed any antihypertensives had a higher odds of no functional improvement (OR 2.36, 95% CI 1.08-5.34) compared to those not prescribed antihypertensives. Conclusions Patients with a hypertension diagnosis discharged to IRF after AIS are less likely to have functional improvement compared to patients discharged home which may be associated with the prescription of antihypertensive medications.