Abstract
BackgroundHypertension remains the major modifiable risk factor of stroke recurrence. The study aimed to determine the up-to-date epidemiological features of hypertension among the survivors of ischemic stroke.MethodsOur cross-sectional study included 18,796 adults aged ≥40 years and residing in northeast China. Ischemic stroke was diagnosed according to the World Health Organization’s criteria, which requires the clinical record, computed tomography (CT) and/or magnetic resonance imaging (MRI) during the hospital stay. Hypertension was defined according to the Chinese hypertension guidelines (mean SBP ≥140 mmHg and/or mean DBP ≥90 mmHg, and/or self-reported use of anti-hypertensive medication in the past 2 weeks).ResultsOf the 986 survivors of ischemic stroke, 819 (83.1%) were identified with hypertension (535 were pre-stroke hypertension and 284 were post-stroke hypertension). Among hypertensive patients, the awareness and treatment rates were 76.8 and 66.7% respectively. Only 11.0% achieved an appropriate blood pressure (< 140 mmHg and < 90 mmHg) among those who took hypertensive medications. 16.8% of treated hypertensive patients received combination therapy, and calcium channel blockers were the most frequently used anti-hypertensive medication as monotherapy. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the stroke population was 155.3 ± 22.9 mmHg and 89.2 ± 12.3 mmHg. Both SBP and DBP were higher in rural patients than in urban patients (158.5 ± 23.8 mmHg vs. 146.4 ± 17.5 mmHg and 90.3 ± 12.9 mmHg vs. 85.9 ± 10.1 mmHg, respectively; p < 0.001). The rates of stage 2 and above hypertension in the ischemic stroke population were 32.5 and 18.7%, and was significantly higher in rural areas than in urban areas.ConclusionsThe prevalence of poorly-controlled hypertension and the high rates of blood pressures at stages 2 and above in patients with prior ischemic stroke demonstrated an alarming situation in northeast China.
Highlights
Hypertension remains the major modifiable risk factor of stroke recurrence
We found that hypertension was prevalent in rural northeast China’s stroke population [7]; detailed information regarding this remains unclear
The mean systolic blood pressure (SBP) were higher in women patients than in men patients (157.0 ± 23.4 mmHg vs. 153.6 ± 22.3 mmHg, respectively; p = 0.019); the diastolic blood pressure (DBP) levels in the men ischemic stroke population was higher than that of women (90.1 ± 12.0 mmHg vs. 88.2 ± 12.6 mmHg, respectively; p = 0.018) (Fig. 2)
Summary
Hypertension remains the major modifiable risk factor of stroke recurrence. The study aimed to determine the up-to-date epidemiological features of hypertension among the survivors of ischemic stroke. In China, where one-fifth of the world’s population resides, more than 2 million people are affected annually by stroke, contributing to a high disability-adjusted life-years (DALY) loss [2, 3]. The burden of stroke in China continues to increase due to an aging population, cultural changes in life-style, and a high prevalence and poor management of related risk factors [3]. In China, stroke was responsible for nearly 1.5 million premature deaths in 2017, the years of life lost (YLLs) caused by stroke has increased 14.6% from 1990 to 2017 [4]. Stroke recurrence remains an ongoing health concern and secondary prevention must be emphasized
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