Blood Pressure Control among Hypertensive Stroke Survivors in Nigeria

• Published in: Journal of stroke and cerebrovascular diseases Vol. 26; no. 6; pp. 1222 - 1227
• Main Authors: Wahab, Kolawole Wasiu, FMCP, Kolo, Philip Manma, FMCP, Salawu, Fatai K., FMCP, FWACP, Sanya, Emmanuel O., FWACP
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2017
• Subjects: Aged; Antihypertensive Agents - therapeutic use; Blood Pressure - drug effects; blood pressure control; Cardiovascular; Chi-Square Distribution; Cross-Sectional Studies; Educational Status; Female; Humans; hypertension; Hypertension - diagnosis; Hypertension - drug therapy; Hypertension - epidemiology; Hypertension - physiopathology; Logistic Models; Male; Medication Adherence; Middle Aged; Neurology; Nigeria; Nigeria - epidemiology; Odds Ratio; Prevalence; Risk Assessment; Risk Factors; Stroke; Stroke - diagnosis; Stroke - epidemiology; Stroke - physiopathology; Stroke - therapy; stroke survivors; Tertiary Care Centers; Time Factors; Treatment Outcome; Stroke; stroke survivors; blood pressure control; Nigeria; hypertension
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2017.01.011

Background Hypertension is the dominant risk factor for first-ever and recurrent stroke. The objective of the present study was to assess control of blood pressure (BP) among hypertensive stroke survivors seen at 2 tertiary hospitals in Nigeria. Methods Using a cross-sectional design, stroke survivors with hypertension as a risk factor were consecutively recruited in the outpatient clinics of the participating hospitals. After the necessary demographic and clinical information had been obtained, participants had their BP assessed in a standardized manner. A BP of <140/< 90 mmHg was defined as good control. Univariate binary logistic regression analysis was performed to determine the predictors of good BP control. Results There were 284 subjects with a mean age of 59.0 ± 13.1 years. The overall mean systolic blood pressure was 142.7 ± 22.5 mmHg (male 144.9 ± 22.7, female 138.4 ± 21.6; P  > .05) while the overall mean diastolic blood pressure was 85.6 ± 14.5 mmHg (male 85.8 ± 14.6, female 85.2 ± 14.4; P  > .05). In spite of the fact that 270 (95.1%) of the subjects were on antihypertensives, only 39.8% (male 37.0%, female 44.1%; P  > .05) had good BP control. In univariate analysis, having at least 12 years of formal education (OR 1.672, 95% CI 1.035-2.699; P  < .05) and good compliance to antihypertensive medications (OR 9.732, 95% CI 3.391-27.930; P  < .001) were the only variables associated with good BP control. Conclusions Control of BP is poor among Nigerian hypertensive stroke survivors and is associated with the level of formal education and drug compliance. Urgent measures are needed to improve on this poor BP control as these may potentially reduce stroke recurrence rate.