Project Summary
This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is the research about?
Having a stroke increases the risk of having another stroke in the future. Controlling blood pressure can help prevent another stroke for stroke survivors.
In this study, the research team is comparing two ways to control high blood pressure in the first six months after a stroke. The first way is by providing care through telehealth. Telehealth is a way to provide care to patients remotely using phone, video, or monitoring devices that can help manage care. The second way is using clinic-based care and monitoring.
Who can this research help?
Results may help stroke survivors and doctors when considering ways to control blood pressure after a stroke.
What is the research team doing?
The research team is enrolling 3,200 patients who had a stroke and have high blood pressure. The team is assigning patients by chance to receive intensive blood pressure management either by telehealth or through in-person care at the clinic.
Telehealth consists of:
- Remote blood pressure monitors patients use at home that report blood pressure to the healthcare team
- A tailored care plan focused on controlling blood pressure
- Referrals to community services such as stroke support groups and help getting food, medicine, and transportation
- Follow-up with doctors via telehealth every two months or as needed to adjust blood pressure medicines
- Help from a health coach to manage medicines and make changes to diet and exercise
In-person care consists of:
- In-person clinic visits with a stroke healthcare team every 30 days until patients’ blood pressure is under control, then every two months
- Care planning focused on blood pressure and other stroke risks
- General health education from a health coach on diet and exercise
The research team is measuring patients’ blood pressure at the start of the study and again 6 and 12 months later. The team is also reviewing health records to look at hospital stays and deaths due to heart attack or stroke. Patients are completing surveys on their knowledge, skills, and confidence in managing their health.
Stroke survivors, caregivers, doctors, health insurers, and policy makers are helping to plan and conduct this study.
Research methods at a glance
| Design Element | Description |
|---|---|
| Design | Randomized controlled trial |
| Population | 3,200 adults who had an ischemic or hemorrhagic stroke with systolic blood pressure ≥130 mmHg |
| Interventions/ Comparators |
|
| Outcomes |
Primary: proportion of patients with systolic blood pressure ≤130 mmHg Secondary: change in systolic blood pressure, incidence of major adverse cardiovascular events, patient activation for blood pressure management (i.e., knowledge, skill, and confidence to manage blood pressure), physical function and disability, cognitive function, medication adherence, satisfaction with care |
| Timeframe | 6-month follow-up for primary outcome |