{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T22:33:59Z","timestamp":1768602839464,"version":"3.49.0"},"posted":{"date-parts":[[2023,2,16]]},"group-title":"Neurology","reference-count":38,"publisher":"openRxiv","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2023,2,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Guideline based hypertension management is integral to the prevention of stroke. We examine trends in antihypertensive medications prescribed after stroke and assess how well a prescribers\u2019 blood pressure medication choice adheres to clinical practice guidelines (Prescribers\u2019-Choice Adherence).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The Florida Stroke registry (FSR) utilizes statewide data prospectively collected for all acute stroke admissions. Based on established guidelines we defined optimal Prescribers\u2019-Choice Adherence using the following hierarchy of rules: 1) use of an angiotensin inhibitor (ACEI) or angiotensin receptor blocker (ARB) as first-line antihypertensive among diabetics; 2) use of thiazide-type diuretics or calcium channel blockers (CCB) among African-American patients; 3) use of beta-adrenergic blockers (BB) among patients with compelling cardiac indication (CCI) 4) use of thiazide, ACEI\/ARB or CCB class as first-line in all others; 5) BB should be avoided as first line unless CCI.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>A total of 372,254 cases from January 2010 to March 2020 are in FSR with a diagnosis of acute ischemic, hemorrhagic stroke, transient ischemic attack or subarachnoid hemorrhage; 265,409 with complete data were included in the final analysis. Mean age 70 +\/-14 years, 50% female, index stroke subtype of 74% acute ischemic stroke and 11% intracerebral hemorrhage. Prescribers\u2019-Choice Adherence to each specific rule ranged from 48-74% which is below quality standards of 85%. There were race-ethnic disparities with only 49% Prescribers choice Adherence for African Americans patients.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This large dataset demonstrates consistently low rates of Prescribers\u2019-Choice Adherence over 10 years. There is an opportunity for quality improvement in hypertensive management after stroke.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2023.02.15.23286003","type":"posted-content","created":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T18:50:10Z","timestamp":1676573410000},"source":"Crossref","is-referenced-by-count":1,"title":["A 10-year review of antihypertensive prescribing practices after stroke and the associated disparities from the Florida Stroke Registry"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3991-3179","authenticated-orcid":false,"given":"Gillian 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