Telemedicine and Innovative Scoring Enhance Safety in Post-Stroke Hypertension Management

Recent advancements in stroke care have introduced promising strategies to improve the management of hypertension following intracerebral hemorrhage (ICH). Researchers from The University of Hong Kong's HKU Stroke team have developed the TRICH score, a new clinical tool aimed at identifying ICH patients who would benefit from early and aggressive blood pressure control with triple antihypertensive medications.

The TRICH score simplifies risk assessment by considering five key factors: age, sex, kidney function, admission blood pressure, and the presence of ischemic heart disease. Validated across three local hospitals—Ruttonjee, Yan Chai, and Princess Margaret Hospitals—the score enables clinicians to quickly determine which patients require prompt, intensive treatment to prevent ICH recurrence and reduce long-term disability risks.

Hemorrhagic stroke, constituting about half of stroke-related deaths in Asian populations, demands precise blood pressure management. Studies indicate that many ICH patients fail to achieve optimal blood pressure control, escalating the chances of further strokes and mortality. While multiple antihypertensive medications are often necessary, concerns about overtreatment and side effects, especially in older patients, complicate care.

The researchers emphasized that timely use of the TRICH score can enhance decision-making, allowing healthcare providers to prescribe combination therapies effectively. Dr. Teo Kay-cheong highlighted the importance of controlling blood pressure—"since poorly managed hypertension increases ICH and stroke risks up to four times," he stated.

Complementing the scoring system, HKU Stroke is exploring the role of telemedicine through the MOBILE-ICH study, assessing its safety and efficacy in managing hypertension among ICH survivors. This approach aims to ensure consistent blood pressure monitoring and medication adherence, especially critical given the high prevalence of undiagnosed or untreated hypertension among younger stroke patients.

Furthermore, addressing hypertension broadly is vital in stroke prevention. Experts note that many younger individuals with stroke have undetected hypertension, underscoring the need for wider screening and early intervention. As Dr. Gary Lau Kui-kai pointed out, "Hypertension remains the leading modifiable risk factor for stroke, and proactive management could prevent many cases." The integration of innovative scoring systems and telehealth solutions marks a significant step toward safer, more effective post-stroke care.

Source: https://medicalxpress.com/news/2025-05-telemedicine-scoring-safer-hypertension.html