Antihypertensive Drug Use and Adherence After Stroke
Bibliographic record
Abstract
BACKGROUND AND PURPOSE: The majority of stroke fatalities occur in elderly women. We compared prescribing and adherence to antihypertensive therapies shown to reduce fatal and nonfatal stroke recurrence among elderly women and men with acute stroke. METHODS: Using the Registry of the Canadian Stroke Network, we identified all patients >or=66 years of age discharged home from 11 tertiary care centers with acute stroke (July 1, 2003, through March 31, 2006) in Ontario, Canada. Stroke cases were linked to the Ontario Drug Benefits Database and evaluated for prescription claims for thiazide diuretic, angiotensin converting enzyme inhibitor, beta blocker, angiotensin receptor blocker, or calcium channel blocker within 1 year of discharge from hospital. One-year adherence was assessed using the proportion of days covered with suboptimal adherence defined as a proportion of days covered <0.8. RESULTS: A total of 3571 patients (51.6% women) >or=66 years of age with acute stroke were discharged home, with 87.6% of women and 84.7% of men treated with antihypertensive therapy within 1 year of stroke. Men were more likely than women to be prescribed angiotensin converting enzyme inhibitor monotherapy but just as likely to be prescribed angiotensin converting enzyme inhibitor/diuretic combination. Women were more likely to be prescribed all other classes of antihypertensive therapy. Suboptimal adherence occurred in 32% of patients receiving thiazide diuretics, 25% for angiotensin converting enzyme inhibitors, and 38% for angiotensin converting enzyme inhibitor/diuretic combination. There were no sex differences in adherence to these antihypertensive therapies. Patients who died after stroke had lower adherence to antihypertensive therapy compared with those who survived. CONCLUSIONS: In a cohort of elderly stroke patients, women were generally just as likely or more likely than men to receive antihypertensive prescriptions after stroke. Drug adherence was similarly poor in women and men.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".