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Brain & Heart Stroke risk in Nigerians with diabetes and hypertension

conditions. 23,24 Despite the relatively short follow-up stroke occurrence. The correlation of factors such as
period in this study, the risk of stroke among hypertensive female gender, older age, and unemployment with elevated
and diabetic individuals in Nigeria appears to be slightly stroke risk suggests areas where public health efforts could
higher than that observed in developed countries. be focused, particularly in community outreach and
education on risk mitigation. In addition, future research
While our study did not definitively demonstrate a
dose-response relationship between the level of physical could further explore lifestyle factors and healthcare access
as modifiable contributors to stroke risk in similar settings.
activity and stroke risk, prior case–control studies on More rigorous blood pressure and blood glucose control
stroke have consistently shown a strong association protocols, combined with community health initiatives to
between physical inactivity and an increased risk of address lifestyle and employment-related health disparities,
stroke. 25-27 Physical inactivity was associated with a 20% may substantially lower the risk and impact of stroke in
higher stroke risk after accounting for demographic Nigerian hypertensive and diabetic individuals.
and socioeconomic factors. However, this association
weakened when traditional stroke risk factors were also Acknowledgments
considered. Overall, interventions aimed to improve
28
medication adherence, including the use of mobile health None.
technology 29,30 and a cardiovascular polypill containing Funding
generic blood pressure-lowering medications, 31,32 could
enhance HTN management in settings with limited None.
resources. Conflict of interest

Our study has several limitations. First, most of the
participants did not undergo brain imaging, which made The authors declare that they have no competing interests.
it difficult for us to conduct further analysis and could Author contributions
have caused misclassification errors. In addition, some
patients with clinical features of a stroke may not have Conceptualization: Abba Musa Abdullahi, Usman Auwalu
shown neuroimaging features, which could have pave Isah
ways for finding out other possibilities among the patients. Formal analysis: Abba Musa Abdullahi
Second, all the patients we recruited into the studies were Investigation: Abba Musa Abdullahi, Usman Auwalu Isah
outpatients, excluding hospitalized patients, which could Methodology: Abba Musa Abdullahi
have led to a poor reflection of the overall risk. Third, Writing–original draft: Abba Musa Abdullahi
this study was conducted at only two general hospitals, Writing–review & editing: Usman Auwalu Isah
which may restrict the extent to which our findings can be
applied to other healthcare settings. As a result, we were Ethics approval and consent to participate
unable to estimate the overall risk of stroke occurrence The study was approved by the Health Research Ethics
among patients with HTN and diabetes within the broader Committee Kano Ministry of Health with the reference
population. Fourth, the measurement criteria for both number: MOH/Off/797/T.1/2022. The requirement for
blood pressure and diabetes may have differed between the obtaining informed consent from patients has been waived
two hospitals, and this may have influenced the calculated due to the minimal risk associated with the study.
risk of stroke occurrence across groups. Given the lack
of imaging resources and the limited scope of stroke care Consent for publication
services in Nigeria, it can be deducted from this study that The requirement for obtaining informed consent from
implementing accessible, community-based preventive patients has been waived due to the minimal risk associated
measures and increasing the availability of affordable HTN with the study.
and diabetes management options could reduce stroke
incidence. Availability of data

5. Conclusion Data are available from the corresponding author on
reasonable request.
The findings of this study highlight a significant risk of
stroke among Nigerian patients with HTN, diabetes, and References
particularly those with both conditions. This underscores 1. Lemogoum D, Degaute JP, Bovet P. Stroke prevention,
the urgent need for interventions targeting blood pressure treatment, and rehabilitation in sub-Saharan Africa. Am J
and blood sugar control among high-risk groups to prevent Prev Med. 2005;29(5S1):95-101.

Volume 3 Issue 1 (2025) 7 doi: 10.36922/bh.5722