Patients with a previous stroke attack who suffer from blood pressure control or regulation in Saudi Arabia

Khaled M. Hassan, Abdulwahab A. Alqahtani, Mohammed W. Alotaibi, Abdulaziz A. Alahmari, Salwa M. Alanazi, Ghadah O. Al-Hussain, Mesedah A. Alnahdi, Faisal A. Alharbi, Ahmed A. Alshehri, Ziyad A. Aloraini, Sulaiman H. Almutairi, Bara A. Baw, Bader A. Alamer, Khaled M. Alsassiri, Maha A. Alfaraj, Abdulmohsen M. Alotaibi


This study aims to discuss the blood pressure (BP) control with patients who suffer from a previous stroke or transient ischemic attack (TIA) in Saudi Arabia, to discuss the risk factors and to examine antihypertensive medication-dosing. The most recent office-based BP reading was compared with the BP <140/90 mmHg objective of the National Institute for Health and Care Excellence (NICE) (NG136) and European Society of Hypertension or European Society of Cardiology (ESH/ESC 2013) study participants. By benchmarking prescription doses for each drug with the World Health Organization-defined daily dosing (WHO-DDD) guidelines, optimal anti-hypertensive medication dosing was calculated. In 10 procedures, we found 328 patients with a prior stroke or TIA. When assessed against the ESH/ESC and NICE guidelines (63.1 percent, n=207), blood pressure was controlled in nearly two-thirds of patients. Of those with BP 140/90 (n=116), just under half (n=44, 47.3 percent) were sufficiently dosed relative to the WHO-DDD guidelines in all anti-hypertensive medicines. To conclude, in at least one-third of patients with a prior stroke or TIA, blood pressure regulation remains sub-optimal. Half of these patients were able to respond to an elevation of the anti-hypertensive dose. Further analysis is needed to see how best to control blood pressure in primary care patients with a previous stroke or TIA, since the majority of hypertension consultations take place in this setting.


Blood pressure control, Previous stroke, Transient ischemic attack, Primary care, Saudi Arabia

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