ABSTRACT NUMBER: ESOC2026A2013 IN PURSUIT OF THE NHS 10-YEAR PLAN - BLOOD PRESSURE AND LIPID TARGET ATTAINMENT AFTER STROKE/TIA IN RURAL ENGLISH PRIMARY CARE: A REAL-WORLD REVIEW

Abstract Background and aims Optimisation of blood pressure (BP) and lipid levels is central to secondary prevention following cerebrovascular accident (CVA) or transient ischaemic attack (TIA). While national and European guidelines emphasise aggressive risk-factor modification, real-world data from rural UK general practice are limited. This study evaluated BP and lipid management in a rural East of England primary care population with established CVA/TIA. Methods A retrospective review of anonymised electronic primary care records was undertaken across rural general practices in England. Adults with a documented history of CVA or TIA were included. Extracted variables included age, gender, comorbidities, most recent systolic/diastolic BP, LDL-cholesterol (LDL-C), body mass index, and digital access. The review was conducted as a service evaluation with local ethics approval. Outcomes were assessed against contemporary secondary prevention targets. Results A total of 273 patients were included (mean age 72.8±12.9years; 50.5% male). Mean systolic BP was 126.7±18.2mmHg and mean diastolic BP 73.4±11.7mmHg, with the majority achieving post-stroke BP targets (<130/80 mmHg). Mean LDL-C was 1.71±1.44mmol/L; although many met guideline targets (<1.8 mmol/L), a clinically important subgroup remained above target, indicating residual atherosclerotic cardiovascular risk. Overweight and obesity was common and frequently co-existing with diabetes and/or CKD. Most patients reported access to mobile phone technology. Conclusions In rural this general practice, BP control following CVA/TIA was largely optimised, whereas lipid management remained variable. These findings highlight persistent risk and supports the need for intensified, integrated cardiometabolic strategies in primary care, with digitally enabled and carer-inclusive approaches to improve secondary stroke prevention. Conflict of interest Dr C Deaney has received honoraria/grants from Amarin, Amenarini, AZ, Chiesi, Daiichi Sankyo, Ferring, GSK, Idorsia, Novartis, and Novo Nordisk.