SUCCEED: Community-based care fails to decrease systolic BP after stroke
Community and chronic care model teams did not improve systolic BP more than usual care in patients with recent stroke or transient ischemic attack, according to data from the SUCCEED trial presented at the International Stroke Conference.
Amytis Towfighi, MD, associate professor of neurology (clinical scholar) at Keck School of Medicine of the University of Southern California, director of neurological services and innovation for Los Angeles County Department of Health Services and associate chief medical officer and chair of the neurology department at Rancho Los Amigos National Rehabilitation Center in Downey, California, and colleagues analyzed data from 487 patients (mean age, 57 years; 35% women; 71% Hispanic; 18% black) who had a TIA, ischemic or hemorrhagic stroke within 90 days and had a systolic BP of at least 130 mm Hg.
Patients were assigned an intervention (n = 241) or usual care (n = 246). The intervention was composed of at least three advanced practice provider clinic visits, chronic disease self-management program workshops, at least three community health worker home visits and care coordination that was aided by a mobile platform.
The primary outcome of interest was systolic BP at 12 months. Secondary outcomes of interest included non-HDL, BMI, physical activity, diet and smoking.
Most of the patients in the study were born outside of the U.S., Spanish-speaking, had less than a 12th-grade education and had either government or no insurance.
During follow-up, systolic BP decreased by 10 mm Hg in patients assigned the intervention and 9 mm Hg in those assigned usual care (P = .76).
There were no significant differences in risk factors other than improvements in self-reported salt intake in the intervention (43% to 87%) and the usual-care group (55% to 83%; P = .03).
“Further analyses will illuminate specific contexts, moderating factors, intervention components, extent of intervention implementation and adaptations that explain these findings and whether subgroups benefited,” Towfighi and colleagues wrote. – by Darlene Dobkowski
Towfighi A, et al. LB14. Presented at: International Stroke Conference; Feb. 6-8, 2019; Honolulu.
Disclosures: The authors report no relevant financial disclosures.