Incidence and predictors of stroke among hypertension patients in Awi Zone public hospitals, Northwest Ethiopia: Retrospective follow-up study

Abstract

BACKGROUND: Stroke is a medical emergency neurologic dysfunction that occurs when blood flow to the brain is interrupted, due to a blockage or bleeding lasting ≥ 24 h, resulting in brain cell death and severe complications. It is the second most common cause of death, next to coronary heart disease. There are limited findings on the incidence of stroke among hypertension patients in Ethiopia. OBJECTIVES: To assess the incidence and predictors of stroke among hypertensive patients at Awi Zone public hospitals, Northwest Ethiopia. METHODS: A hospital-based retrospective follow-up study was conducted among adult hypertensive patients in Awi public hospitals between April 1, 2016 and March 30, 2023. A computer-generated simple random sampling method was used to select 510 study participants. Data were entered using EpiData version 4.6 and Stata version 17 for coding, cleaning, and analysis. In bi-variable analysis, variables with a p-value < 0.25 were selected for multivariable Cox proportional regression analysis. Finally, in multivariable analysis, variables with a p-value < 0.05, and 95% CI with their AHR were used to declare them as predictors. RESULTS: The incidence rate of stroke was 5.53 per 100 person-years [95% CI: 4.60, 6.65]. Rural residence [AHR: 1.88 (95% CI: 1.13, 3.12)], family history of stroke [AHR: 2.52 (95% CI: 1.33, 4.77)], Atrial fibrillation [AHR: 3.10 (95% CI: 1.62, 5.90)], total cholesterol ≥ 200 mg/dl [AHR: 4.42 (95% CI: 2.71, 7.23)], overweight [AHR: 1.82 (95% CI: 1.16, 2.87)], and low-density lipoprotein-cholesterol ≥ 100 mg/dl [AHR: 1.77 (95% CI: 1.11, 2.83)] were statistically significant. CONCLUSIONS: In this study, the incidence rate of stroke was 5.5 per 100 person-years. Rural residence, overweight, atrial fibrillation, high levels of cholesterol and low-density lipoprotein-cholesterol, and a positive family history of stroke were identified as predictors of stroke. To lower the incidence of stroke among hypertension patients, patients should adopt healthy lifestyles such as weight loss and healthy eating, and healthcare professionals should pay special attention to patients presenting with known risk factors.