Frequency of Hypertension in Ischemic and Hemorrhagic Strokes: A Cross-sectional Study at a Tertiary Care Hospital of Multan, South-Punjab Pakistan

Abstract

Background: Stroke is a global health problem. Stroke is responsible for major disabilities in adult population, and is 2^nd leading cause of deaths all over the world. Estimated 15 million people all over the world become victim of stroke every year all over the world, of which 5 million die and other 5 million are left permanently disabled and thus major burden on the sufferer and families as well. Different studies have reported hypertension as major cause of stroke in different populations.

Objective: To determine the frequency of hypertension among ischemic stroke and hemorrhagic stroke at a tertiary care hospital.

Subjects and Methods: Our study included 246 stroke patients which were recruited from Department of Medicine Nishtar Medical University Hospital Multan. Specific history concerning hypertension was inquired from all patients. Blood pressure of all the patients was measured. Blood pressure levels were measured by researcher using random-zero sphygmomanometers with the subject seated quietly. Two readings of blood pressure were taken and average   of the two readings was noted in the proforma. ECG of all the patients was done and checked for the fulfillness of criteria of left ventricular hypertrophy i.e. Sokolow-Lyon Index, Cornell Voltage Criteria.

Results: Our  study included 246 stroke patients, 160 (65%) were male patients and 86 (35%) were female patients. Mean age of our study cases was 59.63 + 11.24 years. Ischemic stroke was observed in 133 (54.1%) of our study cases, while hemorrhagic stroke was noted in 113 (45.9%) of our study cases and 13 (5.3%) had previous history of stroke as well. Smoking was observed in 110 (44.7%) of our study cases and all the smokers were male patients. Alcohol consumption and family history of stroke was zero in our study cases. Of these  246  stroke patients, 148 (60.2%) were known hypertensive and all of them were taking anti-hypertensive medication. Frequency of hypertension in our study was 168 (68.3%) at presentation.

Conclusion: Higher frequencies of modifiable risk factors was seen with Hypertension was the leading risk factor of stroke in our study. These findings point towards well directed efforts regarding conventional interventions in our population. Hemorrhagic stroke was significantly associated with elevated blood pressure. Hypertension was significantly associated with increasing age, diabetes, previous history of stroke, hemorrhagic stroke and smoking in stroke patients.

Keywords: Stroke, Hypertension, Ischemic, hemorrhagic.