Poststroke hypertension in Africa

Stroke. 2012 Dec;43(12):3402-4. doi: 10.1161/STROKEAHA.112.672485. Epub 2012 Sep 25.

Abstract

Background and purpose: Little is known about the frequency of hypertension and related knowledge in Africans who have had a stroke. The objective of this study was to determine the frequency of hypertension, its control, and associated knowledge among patients with and without a history of stroke at Uganda's main referral hospital.

Methods: Subjects with a history of stroke (n=157) were compared with stroke-free control subjects (n=149). Demographics and clinical characteristics were recorded and hypertension-related knowledge assessed by questionnaire. Multiple logistic regression including cases and control subjects was used to determine factors independently associated with blood pressure control and hypertension-related knowledge.

Results: A total of 69.4% of cases versus 54.7% of control subjects were hypertensive at the time of the research visit (P=0.001). Univariable analyses showed the odds of having good blood pressure control (OR, 0.53; 95% CI, 0.33-0.84; P=0.006) and good hypertension knowledge (OR, 0.35; 95% CI, 0.22-0.56; P<0.0001) were lower in cases. Age <40 years (P=0.002), good hypertension-related knowledge (P=0.002), and poorer medication adherence (P<0.0001) were independently associated with poorer blood pressure control. Those with a history of hypertension had better hypertension-related knowledge (P=0.001), but knowledge was poorer among cases (P<0.0001).

Conclusions: Hypertension is common in Ugandans with and without a history of stroke. Barriers to effective blood pressure control in Uganda other than patient knowledge need to be identified.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Blood Pressure
  • Female
  • Health Knowledge, Attitudes, Practice / ethnology*
  • Hospitals / statistics & numerical data
  • Humans
  • Hypertension / ethnology*
  • Hypertension / psychology*
  • Logistic Models
  • Male
  • Middle Aged
  • Stroke / ethnology*
  • Stroke / psychology*
  • Surveys and Questionnaires
  • Tertiary Care Centers / statistics & numerical data
  • Uganda / epidemiology