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The UNC Gillings School of Global Public Health and Wake Forest School of Medicine will lead a $29.9 million effort to help stroke survivors prevent another stroke by controlling blood pressure.

For those trying to avoid a second stroke, blood pressure control is key. However, 70% to 80% of stroke survivors have high blood pressure and urgently need more help controlling it. 

The Patient-Centered Outcomes Research Institute is funding the six-year study, which will compare the effectiveness of in-person care to remote monitoring with a Bluetooth-enabled blood pressure cuff among 3,200 stroke patients.  

Recurrent strokes can be prevented, which inspired study principal investigator Cheryl Bushnell, a neurologist and director of the Comprehensive Stroke Center at Wake Forest, and co-principal investigator Wayne Rosamond, professor of epidemiology at UNC Gillings School of Global Public Health, to look at which prevention methods work best.  

“This study will help inform decisions for stroke survivors and their doctors about managing blood pressure after stroke,” said Rosamond. “In particular we hope to identify optimal approaches to care for those at the highest risk for having uncontrolled high pressure and another stroke: African Americans, the elderly, and people with physical and cognitive disabilities.”   

Gillings will receive $8.2 million to lead data coordination of the study that could impact stroke care across the country.  

The Gillings study team includes stroke prevention researcher Sara Jones Berkeley, an assistant professor of epidemiology, and Matthew Psioda, director of Innovative Trials at the Collaborative Studies Coordinating Center and an assistant professor of biostatistics.  

Telemedicine vs. in-person care 

Researchers will test two different ways to control high blood pressure in the first six months after a stroke.  

The first way is to teach the patient to use a Bluetooth-enabled blood pressure cuff at home and to provide clinical care remotely. The second way is to measure the patient’s blood pressure frequently at a clinic and provide clinical care in person.  

The study brings together clinics from across the ‘Stroke Belt’ – states in the Southeast with high rates of stroke – including UNC Medical Center, Duke University Medical Center, Medical University of South Carolina, Health Sciences South Carolina, Vanderbilt University Medical Center, Mayo Clinic Florida, University of Alabama Hospital and Erlanger Health. In the Stroke Belt, the risk of stroke is 34% higher than in the rest of the country. 

Adult stroke survivors who are discharged home from participating hospitals and have high blood pressure are eligible to participate in the study.