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Background  Strategies are needed to improve adherence to the blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) level recommendations after stroke and transient ischemic attack (TIA). We investigated whether nurse-led, telephone-based follow-up that included medication titration was more efficient than usual care in improving BP and LDL-C levels 36 months after discharge following stroke or TIA.    Methods  All patients admitted for stroke or TIA at Östersund hospital that could participate in the telephone-based follow-up were considered eligible. Participants were randomized to either nurse-led, telephone-based follow-up (intervention) or usual care (control). BP and LDL-C were measured one month after discharge and yearly thereafter. Intervention group patients who did not meet the target values received additional follow-up, including lifestyle counselling and medication titration, to reach their treatment goals (BP < 140/90 mmHg, LDL-C < 2.5 mmol/L). The primary outcome was the systolic BP level 36 months after discharge.    Results  Out of 871 randomized patients, 660 completed the 36-month follow-up. The mean systolic and diastolic BP values in the intervention group were 128.1 mmHg (95% CI 125.8–130.5) and 75.3 mmHg (95% CI 73.8–76.9), respectively. This was 6.1 mmHg (95% CI 3.6–8.6,  p  < 0.001) and 3.4 mmHg (95% CI 1.8–5.1,  p  < 0.001) lower than in the control group. The mean LDL-C level was 2.2 mmol/L in the intervention group, which was 0.3 mmol/L (95% CI 0.2–0.5,  p  < 0.001) lower than in controls. A larger proportion of the intervention group reached the treatment goal for BP (systolic: 79.4% vs. 55.3%,  p  < 0.001; diastolic: 90.3% vs. 77.9%,  p  < 0.001) as well as for LDL-C (69.3% vs. 48.9%,  p  < 0.001).    Conclusions  Compared with usual care, a nurse-led telephone-based intervention that included medication titration after stroke or TIA improved BP and LDL-C levels and increased the proportion of patients that reached the treatment target 36 months after discharge.    Trial registration  ISRCTN Registry  ISRCTN23868518  (retrospectively registered, June 19, 2012).    Electronic supplementary material  The online version of this article (10.1186/s12883-018-1158-5) contains supplementary material, which is available to authorized users.

bmc neurology

Long-term, telephone-based follow-up after stroke and TIA improves risk factors: 36-month results from the randomized controlled NAILED stroke risk factor trial