INCIDENCE OF ACUTE ISCHEMIC STROKE IN HYPERTENSIVE PATIENTS IN LAHORE, PAKISTAN
DOI:
https://doi.org/10.32734/idjpcr.v8i02.22416Keywords:
Acute ischemic stroke, brain CT scan, diabetes mellitus, hypertension, ischemic heart disease, Lahore, PakistanAbstract
This study aimed to determine the incidence of acute ischemic stroke in hypertensive individuals in Lahore, Pakistan, and was conducted at the Department of Medicine, Chaudhary Muhammad Akram Teaching and Research Hospital. Hypertension was defined as blood pressure exceeding 140/90 mmHg on two separate occasions, ambulatory readings above 140/90 mmHg recorded at least 15 days apart, or a known history of antihypertensive medication use. Acute ischemic stroke was defined as sudden loss or weakness in function of one or more limbs on clinical examination, confirmed radiologically by a CT scan of the brain. A total of 200 hypertensive patients aged 18 years and older were included using non-probability consecutive sampling. Participants underwent evaluation for blood pressure control, antihypertensive therapy, comorbidities, and acute ischemic stroke. The results showed that acute ischemic stroke was present in 6.5% of patients. Chi-square analysis revealed that prolonged duration of hypertension, poor hypertension control, current treatment regimen, presence of diabetes mellitus, and ischemic heart disease had statistical associations with stroke. However, in logistic regression analysis, no variable was found to be a significant predictor of stroke. It is concluded that acute ischemic stroke is not an uncommon finding in hypertensive patients, being more prevalent in those with prolonged hypertension duration, poor control, and the presence of comorbidities.
Downloads
References
[1] Butsing N, Thongniran N, Keandoungchun J. Changes in functional outcome after a first-time stroke: Data from a longitudinal study. PLoS One. 2025;20(8):e0330086. doi: 10.1371/journal.pone.0330086.
[2] Khan MI, Khan JI, Ahmed SI, Haq U. The epidemiology of stroke in a developing country (Pakistan). J Neurol Stroke. 2018;8(1):32–40. doi: 10.15406/jnsk.2018.08.00275.
[3] Misgana S, Asemahagn MA, Atnafu DD, Assemie MA, Kassa GM. Incidence of stroke and its predictors among hypertensive patients in Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia: a retrospective follow-up study. Eur J Med Res. 2023;28:227. doi: 10.1186/s40001-023-01192-6.
[4] Rupasinghe CD, Bokhari SA, Lutfi I, Noureen M, Islam F, Khan M, et al. Frequency of Stroke and Factors Associated With It Among Old Age Hypertensive Patients in Karachi, Pakistan: A Cross-Sectional Study. Cureus. 2022;14(3):e23123. doi: 10.7759/cureus.23123.
[5] Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, et al; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation. 2017;135(10):e146-e603. doi: 10.1161/CIR.0000000000000485.
[6] Gebremariam SA, Yang HS. Types, risk profiles, and outcomes of stroke patients in a tertiary teaching hospital in northern Ethiopia. eNeurologicalSci. 2016;3:41-47. doi: 10.1016/j.ensci.2016.02.010.
[7] Furie K. Epidemiology and Primary Prevention of Stroke. Continuum (Minneap Minn). 2020;26(2):260-267. doi: 10.1212/CON.0000000000000831.
[8] Butt NI, Ghoauri MSA, Sabeh D, Waris U, Waris B, Jabbar R. Prevalence of hypertension and its association with diabetic complications in patients with type 2 diabetes mellitus at a tertiary care hospital. J Med Res Rev. 2024;3:58–63. doi: 10.5455/JMRR.20241016103141.
[9] Ghoauri MSAJ, Butt NI, Sabeh D, Waris U, Shafiq MM, Javed MU. Incidence of acute ischemic stroke among type 2 diabetic patients in a tertiary care setting. Pakistan Journal of Rehabilitation. 2025;14(1):152-159. doi: 10.36283/pjr.zu.14.1/019.
[10] Yang N, Liu T, Long H, Chen R, Zhu Z, Wang Y, et al. Global burden of male smoking-induced stroke, 1990-2021, and 20-year projections: an analysis of the 2021 Global Burden of Disease Study. BMC Public Health. 2025;25(1):2694. doi: 10.1186/s12889-025-24021-3.
[11] Waris B, Butt NI, Afzal A, Ghoauri MSA, Khizar I, Mahmood K, et al. Exploring Knowledge of Hypertension and Treatment Adherence in Hypertensive Patients From Lahore, Pakistan. Cureus. 2025;17(4):e81762. doi: 10.7759/cureus.81762.
[12] Owolabi MO, Agunloye AM. Risk factors for stroke among patients with hypertension: a case-control study. J Neurol Sci. 2013;325(1-2):51-6. doi: 10.1016/j.jns.2012.11.016.
[13] Mekonen HH, Birhanu MM, Mossie TB, Gebreslassie HT. Factors associated with stroke among adult patients with hypertension in Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia, 2018: A case-control study. PLoS One. 2020;15(2):e0228650. doi: 10.1371/journal.pone.0228650.
[14] Xia X, Yue W, Chao B, Li M, Cao L, Wang L, et al. Prevalence and risk factors of stroke in the elderly in Northern China: data from the National Stroke Screening Survey. J Neurol. 2019;266(6):1449-1458. doi: 10.1007/s00415-019-09281-5.
[15] Reddin C, Canavan M, Hankey GJ, Oveisgharan S, Langhorne P, Wang X, et al; INTERSTROKE investigators. Association of Vascular Risk With Severe vs Non-Severe Stroke: An Analysis of the INTERSTROKE Study. Neurology. 2024;103(11):e210087. doi: 10.1212/WNL.0000000000210087.
[16] Mead GE, Sposato LA, Sampaio-Silva G, Yperzeele L, Wu S, Kutlubaev M, et al. A systematic review and synthesis of global stroke guidelines on behalf of the World Stroke Organization. Int J Stroke. 2023;18(5):499-531. doi: 10.1177/17474930231156753.
[17] Cho JH, Rhee EJ, Park SE, Kwon H, Jung JH, Han KD, et al; Taskforce Team of the Obesity Fact Sheet of the Korean Society for the Study of Obesity. Maintenance of body weight is an important determinant for the risk of ischemic stroke: A nationwide population-based cohort study. PLoS One. 2019;14(1):e0210153. doi: 10.1371/journal.pone.0210153.
[18] Sarfo FS, Asowata OJ, Akpa OM, Akinyemi J, Wahab K, Singh A, et al. Stroke occurrence by hypertension treatment status in Ghana and Nigeria: A case-control study. J Neurol Sci. 2024;459:122968. doi: 10.1016/j.jns.2024.122968.
[19] Zheng J, Sun Z, Guo X, Xie Y, Sun Y, Zheng L. Blood pressure predictors of stroke in rural Chinese dwellers with hypertension: a large-scale prospective cohort study. BMC Cardiovasc Disord. 2019;19(1):206. doi: 10.1186/s12872-019-1186-0.
[20] Nasim H, Butt NI, Ashfaq F, Anwar A, Aftab S, Muaaz M. Frequency of Modifiable Risk Factors in Ischemic Stroke Patients at a Tertiary Care Hospital in Lahore Pakistan. Pak J Med Res. 2023;62(2):53-58.
[21] Cipolla MJ, Liebeskind DS, Chan SL. The importance of comorbidities in ischemic stroke: Impact of hypertension on the cerebral circulation. J Cereb Blood Flow Metab. 2018;38(12):2129-2149. doi: 10.1177/0271678X18800589.
[22] Webb AJS, Werring DJ. New Insights Into Cerebrovascular Pathophysiology and Hypertension. Stroke. 2022;53(4):1054-1064. doi: 10.1161/STROKEAHA.121.035850.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Indonesian Journal of Pharmaceutical and Clinical Research
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
The Authors submitting a manuscript do so on the understanding that if accepted for publication, copyright of the article shall be assigned to Indonesian Journal of Pharmaceutical and Clinical Research (IDJPCR) and Faculty of Pharmacy as well as TALENTA Publisher Universitas Sumatera Utara as publisher of the journal.
Copyright encompasses exclusive rights to reproduce and deliver the article in all form and media. The reproduction of any part of this journal, its storage in databases and its transmission by any form or media, will be allowed only with a written permission from Indonesian Journal of Pharmaceutical and Clinical Research (IDJPCR).
The Copyright Transfer Form can be downloaded here.
The copyright form should be signed originally and sent to the Editorial Office in the form of original mail or scanned document.
