Association of Modifiable Risk Factors with Ischemic Stroke among Hypertensive Patients (Case Control Study at Tertiary Care Hospital, Karachi) (original) (raw)

2018, International Journal of Nursing and Hospital Care. Volume 1 Issue 3, June 2018

Title: Association of Modifiable Risk Factors with Ischemic Stroke among Hypertensive Patients: Case Control Study at Tertiary Care Hos- pital, Karachi Objectives: To determine the association of modifiable risk factors (smoking, obesity, physical inactivity, dyslipidemia, diabetes mellitus) with Ischemic stroke among hypertensive patients. Methods: A Case control study, conducted at Medicine and Family Medicine clinics at the Aga Khan University Hospital (AKUH), Karachi from May 2009 to April 2011. Total 288 patients were included through non-probability purposive sampling. All hypertensive patients’ ≥35 years with first ever ischemic stroke and without stroke were enrolled and proforma was filled with consent. Mean and standard deviation was calculated for continuous variables and percentages for categorical variables. Univariate analysis was used to determine the associa- tion of modifiable risk factors with ischemic stroke and multivariate model was created for controlling the effects of confounders. Results: Mean age was 61.2 years ± 12.9 SD. After adjusting for the effects of other variables in the model, the odds of physically inactive among ischemic stroke cases were six times (ORadj=6.867, 95% CI: 3.102-15.204), and odds of lower HDL levels were three times (ORadj= 3.740, 95% CI: 2.105-6.645) as compare to non-stroke controls. Cases were more likely to be obese (ORadj= 1.233, 95% CI: 0.598-2.542), smoking cigarette (ORadj= 2.57, 95% CI: 1.43-4.62), diabetic (ORadj= 1.48, 95% CI: 0.82-2.68) and dyslipidemia (ORadj=2.07, 95% CI: 0.84-5.12) than controls. Conclusions: Risk of stroke increased with modifiable risk factors such as physical inactivity, obesity, smoking, DM, and low HDL levels in patients with hypertensive ischemic stroke. By controlling these modifiable risk factors at primary care level can reduce burden of stroke in the community