Abstract Body: Introduction: Blood pressure (BP) control after a stroke is crucial in lowering the risk of stroke recurrence. Our prior work found that over 60% of patients recently discharged from a regional health system with stroke did not achieve BP control according to current guidelines. Less is known about the impact of insurance type and co-morbidities on post-stroke BP control.

Objective: To analyze the relationship between insurance type, comorbidities and post-stroke BP control among patients within a regional health system.

Methods: This report is an observational cohort study. Patients were admitted between 2013-2021 for ischemic and hemorrhagic stroke and had seen a PCP/PCAPP (primary care physician/primary care advance practice provider) in a regional health system or affiliated outpatient clinics using the EPIC electronic health record. We excluded patients who died during hospitalization, were lost to follow-up, or were on dialysis.

Results: The analysis included 2,750 patients. Six months after hospital discharge, the insurance coverage among stroke survivors with uncontrolled BP (>130/80 mm Hg) was 61.1% for public, 35.8% for private, 1.9% for other/unknown, and 1.3% for self-pay. In comparison, among those with controlled BP (<130/80 mm Hg), the coverage was 63.0% for public, 33.6% for private, 1.9% for other/unknown, and 1.6% for self-pay; a chi-square test showed a non-statistically significant difference (p=0.6026). The comorbidities with a statistically significant difference for BP control were hypertension for the uncontrolled BP group (p=0.0000027) and cancer for the controlled BP group (p=0.00065).

Conclusions: We found that type of insurance is not associated with post-stroke BP control as we did not find a statistically significant difference in the proportion of stroke survivors with uncontrolled versus controlled BP for insurance types. There is a strong association between hypertension and uncontrolled BP suggesting that patients with hypertension are significantly more likely to have uncontrolled BP. Additionally, there is a significant association between cancer and BP control indicating that patients with cancer are more likely to have controlled BP. To the best of our knowledge, this study is the first to analyze insurance type and co-morbidities affecting post-stroke BP control from a regional health system that is not solely self-insured or operating under a global budget.