STROKE IN HYPERTENSIVE PATIENTS

Abstract

Objective: To find the incidence of hypertension in stroke patients comparing it with other common risk factors and to determine the frequency
of occurrence of reactive rise in blood pressure in the acute stage of stroke in normotensive patients. Design: A prospective study. Place &
Duration: The study was conducted in Medical Unit III B V Hospital Bahawalpur from Feb 2001 to May 2002. Patients& Methods: One
hundred consecutive CT Scan confirmed patients of stroke from emergency department were evaluated for various risk factors by using a
proforma to record the biodata, history of hypertension, diabetes mellitus, ischemic heart disease, transient ischemic attacks, smoking and past
history of stroke. After segregating the hypertensive stroke patients, the reactive rise in blood pressure due to acute stage of stroke was also
studied in the normotensive patients. Results: Out of the 1334 admitted patients 7.49% (100 patients) accounted for acute stroke. There were
64 (64%) males and 36 (36%) female patient. 78 patients (78%) had cerebral infarction while 22 (22%) were having hemorrhagic stroke. 49
patients (49%) were hypertensive. Out of these 30 (61.22%) were males and 19 (38.77%) were females. 35 patients (71.42%) had cerebral
infarction while 14 (28.57%) patients had hemorrhagic stroke. Hypertension was a risk factor in 35 out of 78 patients (44.87%) with cerebral
infarction, while it was present in 14 out of 22 patients (63.63%) with hemorrhagic stroke. Comparing hypertension 49% to the other commonly
encountered risk factors in the study, smoking was found in 30%, diabetes mellitus in 19%, ischemic heart disease in 18%, atrial fibrillation in
6% and other cardiac diseases in 4% of all the cases of stroke. Reactive rise in blood pressure in normotensive patients with acute stroke was
found in 51 % (26 out of 51) cases. Conclusion: Hypertension is the most common risk factor for all types of strokes and a significantly high
proportion of normotensive patients show a reactive rise in blood pressure in the acute stage of stroke, which usually becomes normal within
a week, without any anti-hypertensive therapy.