Blood pressure control before and after spontaneous intracerebral haemorrhage: a stroke service audit and strategies for improvement.

In a retrospective audit of 89 adults with spontaneous intracerebral haemorrhage (ICH) at a tertiary neuroscience centre, fewer than 60% met the National Institute for Health and Care Excellence (NICE) blood pressure (BP) target in the year before their haemorrhage, despite most carrying a known diagnosis of hypertension. Blood pressure control and antihypertensive prescribing improved after ICH, yet most survivors remained above the European Stroke Organisation (ESO) secondary-prevention target, and the first documented community BP check occurred a median of 62 days after discharge. These findings expose primary- and secondary-prevention gaps spanning the whole care pathway and lend support to a structured, protocolised uptitration pathway after discharge, combining remote BP monitoring with pharmacist- or nurse-led dose escalation.