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Brain & Heart Stroke risk in Nigerians with diabetes and hypertension

In addition, there are 10.3 million new cases of stroke each child community hospital. Both are government hospitals
year, the majority of which occur in developing nations, within the Kano metropolis that serve a high volume of
leading to significant financial burdens in both developed diabetic and hypertensive outpatients. Most of the patients
and developing nations. 4-6 are mostly Hausa-speaking residents from the metropolis
Hypertension (HTN) is the primary modifiable risk of the state. The guideline used in the design and report
factor for stroke. In addition to its role in stroke, HTN of the research was “The Strengthening the Reporting
is a major contributor to ischemic heart disease, heart of Observational Studies in Epidemiology Checklist for
failure, renal failure, peripheral arterial disease, and aortic Cohort Study.” The Kano Ministry of Health’s Health
disorders, frequently leading to serious complications Research Ethics Committee granted ethical permission for
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and mortality. Globally, the prevalence of stroke is rising the study, with reference number MOH/Off/797/T.1/2022.
An informed consent was obtained by waiver due to the
rapidly among hypertensive individuals, resulting in minimal risk associated with the study, and the study could
significant economic, social, and health burdens. This
is attributed to the higher susceptibility of hypertensive not be conducted without a waiver.
patients to vascular diseases, including stroke. Research 2.2. Participants
has shown that effective management and treatment of
HTN can reduce the risk of stroke by 40% and the risk The study population involved a random sample of
of acute myocardial infarction by 15%. Conversely, an patients aged 18 years or older who had an outpatient’s
increase of 20 millimeters of mercury (mmHg) in systolic department visit from January 2015 through August 2020.
blood pressure (SBP) or 10 mmHg in diastolic blood These patients were identified by manual abstraction
pressure (DBP) is associated with a 50% higher risk of from hospital records using a preformed questionnaire
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stroke. Diabetes mellitus is another significant risk factor and recruited based on the following eligibility criteria:
for stroke development and has become an increasingly (a) stroke symptoms; (b) age >18 years; (c) diagnosis
prevalent health issue in both Africa and Nigeria. of diabetes; (d) diagnosis of HTN; and (e) diagnosis of
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Numerous studies have shown an elevated risk of stroke both HTN and diabetes. Participants who satisfied one
in patients with diabetes mellitus. In Nigeria, diabetes is or more of these categories were excluded: (a) individuals
highly prevalent, with an estimated prevalence ranging with drug-induced diabetes; (b) individuals receiving
from 0.65% to 11%. 10-13 steroid therapy; (c) individuals with chronic malignancies;
(d) individuals with pregnancy-induced HTN or diabetes;
In developing countries like Nigeria, treatment options and (e) patients receiving renal replacement therapy. The
for stroke are lacking, and well-organized stroke services, subjects were divided into three cohort groups which
including emergency transport services, are grossly have similar characteristics: individuals with diabetes
inadequate. In addition, highly effective stroke care is mellitus alone (DM), individuals with both HTN and DM
generally unaffordable in Nigeria, and sociocultural factors (HPT+DM), and those with HPT alone.
greatly influence health-seeking behavior among stroke
patients. Therefore, the aim of this study is to evaluate The study population comprised patients treated
the prevalence and risk of stroke in Nigerians with HTN between January 2015 and August 2020. A sample of
and diabetes mellitus. Since both diabetes and HTN are 39 patients was selected each year, except for 2019, where
common stroke risk factors, comparing these conditions 44 patients were chosen. Within each year, patient selection
will help determine which one poses a higher stroke risk, was randomized, with a minimum of four patients
and whether the combination of diabetes and HTN is randomly selected from each month. Medical records for
linked to an increased stroke risk beyond what is seen with the sampled patients were then reviewed to extract relevant
either condition individually. data for analysis.

2. Materials and methods 2.3. Measurements
Blood pressure was measured on the right arm of each
2.1. Study design and setting participant using a standard mercury sphygmomanometer
We employed an observational research approach using a and an appropriately sized cuff. Before each measurement,
retrospective cohort study, which examines groups of people patients rested for 15 min with their feet on the ground
with shared characteristics yet differing in certain traits and their arm supported at heart level. Fasting blood
linked to a specific outcome. Relevant information for each samples were collected from patients suspected of having
individual was collected from existing records. The study diabetes after an 8-h fasting period. The primary outcome
was carried out at two hospitals in Kano State, Nigeria. One of this study was stroke. To screen for stroke, patients
of which is a general hospital and the other is a maternal and were identified based on the International Classification

Volume 3 Issue 1 (2025) 2 doi: 10.36922/bh.5722