Antihypertensive medication discontinuation after new-onset stroke

ABSTRACT Backgrounds To investigate the proportion of stroke survivors with pre-stroke hypertension who successfully discontinued antihypertensive medication after stroke. Methods This study analyzed data from 9,513 participants from the English Longitudinal Study of Ageing (ELSA; waves 4, 6, and 8) and the China Health and Retirement Longitudinal Study (CHARLS; waves 1, 2, and 3), all of whom received BP measurements across three waves. The BP control status among stroke survivors were reported according to occurrence of hypertension before and after stroke. Results Among these, 262 participants experienced a first-ever stroke during follow-up. After stroke, 12.1% to 13.6% of stroke survivors with pre-stroke hypertension maintained controlled BP in the absence of antihypertensive medication. In the ELSA cohort, the proportion of controlled BP after stroke among hypertensive participants was significantly lower in those with new-onset hypertension after stroke (27.3%) compared to those with pre-stroke hypertension (63.6%, p=0.023). Conclusion Under rigorous BP monitoring, a subset of stroke survivors with pre-stroke hypertension may safely discontinue antihypertensive therapy. Furthermore, stroke survivors with hypertension occurring after stroke may be a key target group for improving post-stroke BP control.