Integrating hypertension control into post-stroke neurorehabilitation: a randomized trial on cognitive and motor recovery outcomes

With a yearly incidence of greater than 150 cases per 100,000 population in Uzbekistan, stroke is a public health problem, with 40% of survivors of stroke having hypertension. This randomized controlled trial in 120 patients (mean age 58 ± 8 years) examined the influence of adding targeted blood pressure control (with a goal systolic blood pressure <130 mmHg) to post-stroke neurorehabilitation protocols. Two groups of intervention patients (standard rehabilitation + blood pressure control) and one control patient group (standard rehabilitation only) were randomly allocated, and patients' outcomes were assessed by means of MMSE (cognitive) and FIM (motor) tests after 3 and 6 months. The intervention group was 25% better in cognitive scores (12% in the control group, p < 0.01) and 40% better in motor scores (FIM score: 85 ± 10 vs. 72 ± 8 in the control group, p < 0.03) at 6 months. In addition, 78% of the patients of the intervention group reached the goal blood pressure (<130/80 mmHg), whereas this achievement was 35% in the control group. The findings show that active control of blood pressure, not just as an adjunctive therapy, but also as a component of rehabilitation protocols for post-stroke patients, highly promotes cognitive-motor recovery and its introduction into the Uzbek healthcare system is advisable.