Objectives To investigate the antithrombotic application to stroke prophylaxis among hypertensive outpatients in China.
Methods Hypertensive outpatients were recruited from 36 tertiary hospitals in 23 provinces or municipalities of China from October 2011 to June 2012. Hypertension was defined under the new criteria “Chinese guidelines for the management of hypertension” issued in 2010. The subjects who had a history of stroke or experienced an acute stroke event, or refused to sign the inform consent were excluded. Face-to-face interviews were conducted by research assistants using questionnaires based on the Framingham stroke risk profile, and data on demographic and clinical characteristics, antithrombotic medication were recorded. A total of 97185 hypertensive outpatients were included in the final analysis.
Results 1. Of all 97185 hypertensive outpatients enrolled in the study, the average (SD) age was 61.16 (11.9) years, and 49.9% were women, 52277 (53.8%) had a medication for antithrombotic therapy. The patients with a history of AF had the highest rate of medication (75.2%), and the rate was lowest among the patients who were smokers (60.8%). 2. 49258 (94.2%) of the patients received aspirin for their primary prevention of stroke, while 1455 (2.8%) of them chose warfarin. Only 28860 (67%) of the patients with CVD were receiving aspirin or clopidogrel as their antithrombotic therapy, and only 963 (16.6%) of the patients with atrial fibrillation were taking warfarin. 3. Among the patients who took aspirin, the dose of 100 mg was most widely used by 86.2% of them, while 7.1% of them preferred the dose of 50mg.
Conclusions Nearly half of the hypertensive outpatients did not receive antithrombotic therapy for the primary prevention of stroke. The medication rate adherence to the guidelines for antithrombotic management in cardiovascular clinics in China is still low, especially among the patients with CVD or AF. Of all kinds of antithrombotic medications, aspirin was the most frequently used. However, Some of the patients did not have adequate dose according to the guidelines for primary prevention of stroke.