Naveeda Khaliq, Nausheen Hussain, Rabia Akhter, Mobeen Iqbal.
Knowledge and perceptions of physicians about Evidence Based Management of hypertension in acute ischemic stroke patients.
Rawal Med J Jan ;35(1):51-3.

Objective: We explored knowledge and perceptions of physicians regarding management of hypertension in acute ischemic stroke patients and use of various anti-hypertensive medicines as primary and secondary prevention of stroke. Subjects and Methods: A survey was designed with 7 statements derived from the recommendations from American Heart Association (AHA)/American Stroke Association stroke council guidelines 2006 and the 7th report of the Joint National Committee (JNC VII 2003). Eighty surveys were distributed to the physicians at Shifa College and Shifa International Hospital, and Pakistan Institute of Medical Sciences, Islamabad. Results: Fifty surveys were returned and the act of responding was taken as consent for participation. Mean duration from graduation (MBBS) was 10.3±9.9 years. When asked about the management of a BP of 170/90 mm Hg in a patient with acute stroke during first 3 and 24 hours, 58.6% and 60% recommended that patient be treated for this blood pressure on these intervals. When asked about the most effective primary prevention for ischemic stroke in a hypertensive patient, 69.7% thought that lowering blood pressure is the single most important factor and 21.2% thought aspirin as the sole first line primary prevention. 22.5% recommended angiotensin converting enzyme inhibitors and or angiotensin receptor blockers as the primary anti- hypertensive therapy for secondary prevention of a hypertensive ischemic stroke. 50% thought that females do not have higher importance as compared with guidelines. Conclusion: There is a considerable gap between evidence based recommendations and actual perceptions of physicians in managing hypertension in stroke patients. This would require an urgent attention to emphasize evidence based practice. (Rawal Med J 2010;35:51-53).

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