Prevalence, Treatment, Control, and Awareness of High Blood Pressure and the Risk of Stroke in Northwest England,

Objectives. The aim of this study was to examine the prevalence, treatment, control, and awareness of hypertension in patients with first-ever stroke and in controls sampled from the same primary care physicianʹs population register. Methods. A population-based case–control study was conducted in East Lancashire, England, using cases identified from the stroke register in 1994–1995. Information on blood pressure (BP) and other predefined factors was extracted from the practice medical records. Postal questionnaires were used for information on patientsʹ awareness of hypertension. Results. A total of 267 stroke cases and 534 controls were included. Sixty-one percent of cases and 43% of controls had BP >= 160/95 mm Hg on >= 2 occasions within 3 months or received antihypertensives. High proportions of cases (82%) and controls (85%) were on treatment. There was a continuous relationship between the risk of stroke and levels of BP control. Of 73 cases and 135 controls who were hypertensive and responded to the postal questionnaire, 56 and 83%, respectively, were aware of hypertension (P < 0.01). Conclusions. The prevalence of hypertension was high among stroke patients. In those treated, <30% of patients had their BP adequately controlled to <140/90 mm Hg. Patient awareness of previous hypertension or high BP was very poor and attention needs to be paid to patient education.