ABSTRACT NUMBER: ESOC2026A2316 A RETROSPECTIVE REVIEW OF SYSTOLIC BLOOD PRESSURE CONTROL AFTER HOSPITAL DISCHARGE FOR STROKE IN A RURAL-CONNECTED ACADEMIC MEDICAL CENTER

Abstract Background and aims High systolic blood pressure is the leading modifiable stroke risk factor for both hemorrhagic and ischemic strokes worldwide. Despite recent advances in hypertension management, the global burden attributable to high systolic blood pressure continues to increase. This is especially true in rural and other resource-limited settings. Methods Retrospective review of stroke patients discharged from a rural-connected academic medical center was conducted to evaluate blood pressure trends and management post-stroke. Hypertension was defined as > 130/80 mmHg. Results 207 patients were discharged during study period, 23 were excluded (9 for alternative diagnosis, and 14 expired). Follow up hospital phone calls occurred in 34% (66/183) (with 64% response rate), 79% (144/183) of patients were seen subsequently by a medical provider and 42% (60/144) were hypertensive. Although hypertension was acknowledged by 53% (32/60) of the providers only 8.3% (5/60) addressed it with a medication change. Similarly, 58% (52/90) of patients remained hypertensive at neurology follow up and only 1.9% (1/52) modified antihypertensive regimen, 19% (10/52) deferred to PCP, 34.6% (18/52) recommended lifestyle changes. Conclusions This study reveals a critical gap in post-stroke blood pressure management despite multiple provider encounters, with a significant proportion of patients remaining hypertensive. These results underscore the urgent need for pragmatic and innovative blood pressure control interventions especially in rural populations with limited access to follow up. Next steps to this study include implementing guideline-based medication algorithms and education for our stroke clinic providers. Other strategies such as electronic medical prompts, patient-centered monitoring, and embedded quality performance measures may also be effective. Conflict of interest Richard Miller nothing to disclose ; Amelia Adcock nothing to disclose ; Mason Shockley nothing to disclose