# Hypertension Improvement Pilot Intervention in Post-Stroke Veterans

> **NIH VA I21** · VA CONNECTICUT HEALTHCARE SYSTEM · 2020 · —

## Abstract

Background: Over 6,000 Veterans are admitted with an acute ischemic stroke annually within the VA
Healthcare System. Nearly 25% of all strokes are recurrent events and constitute a leading cause of disability
and death within our Veteran population, especially among the 75% of Veterans with stroke and hypertension.
Current VA/DoD and American Heart Association/American Stroke Association (AHA/ASA) guidelines stress
the importance of delivering guideline concordant management of hypertension, given the strong association
between goal blood pressure and decreased morbidity and mortality, especially during the six-month post-
stroke period, when most stroke and non-stroke related hospitalizations and deaths occur. Previous Quality
Enhancement Research Initiative (QUERI) work has shown that many Veterans 6-months after their stroke do
not have their blood pressure optimally controlled. Most Veterans receive their post-stroke risk hypertension
care within VA Primary Care and Patient Aligned Care Teams (PACTs). Work performed during the current
Health Services Research and Development (HSR&D) Career Development Award (CDA) period has identified
several areas for intervention that can assist outpatient providers in Primary Care/PACT to better manage
hypertension using existing VA infrastructure, and has led to the development of a bundled, evidence-based,
`Post Stroke Hypertension Improvement Intervention.' Therefore, focusing on prevention of future strokes by
implementing an intervention to effectively treat hypertension among Veterans with stroke is necessary to
improve outcomes in this population.
Objective: To: (1) evaluate the feasibility and acceptability of a pilot intervention, implemented at a single
VAMC providing suboptimal blood pressure management to post-stroke Veterans, during the `high-risk,' 6-
month period post-stroke, such that a more refined intervention can be developed and further informed by key
stakeholders, end users, and strategic partners; and (2) collect metrics related to hypertension control at the
intervention and four control sites.
Methods: A pilot will be initiated at the Michael E. DeBakey VAMC. The Consolidated Framework for
Implementation Research (CFIR) conceptual framework and Systems Redesign strategies will be used to
evaluate the implementation of the intervention. The feasibility and acceptability of the implementation strategy
will be assessed via qualitative interviews with end users of the intervention. Blood pressure will be measured
at baseline, 3-months, and 6-months. The distributions and central tendencies of baseline demographic and
patient-, provider-, and facility-level characteristics for continuous variables will be examined graphically and by
summary statistics. Categorical variables will be examined by calculating frequency distributions. We will
match, based on patient volume and mean facility-level blood pressure, our intervention and control sites.
Hypothesis: We believe that we can: (1) dete...

## Key facts

- **NIH application ID:** 9982060
- **Project number:** 5I21HX002091-02
- **Recipient organization:** VA CONNECTICUT HEALTHCARE SYSTEM
- **Principal Investigator:** Jason Jonathon Sico
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2017-09-01 → 2019-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9982060

## Citation

> US National Institutes of Health, RePORTER application 9982060, Hypertension Improvement Pilot Intervention in Post-Stroke Veterans (5I21HX002091-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9982060. Licensed CC0.

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