engleski

Duration and stage of hypertension as a contributing risk factor for stroke

To determine a proportion of strokes attrib-utable to hypertension in the population of the Osijek region, Eastern Croatia and to assess a possible influence of duration and intensity of hypertension on the stroke occurrence. Although hypertension is considered to be a major risk factor for spoke, proportion of strokes facili-tated by hypertension varies in different population groups. It has been suggested that the risk for stroke rises proportionately with increasing blood pressure. The subjects were recruited from a cohort of 527 stroke patients who had been hospitalized dur-ing consecutive 12 months at the Department of Neurology, Osijek University Hospital, Osijek, Croatia. Diagnoses of hy-pertension were confirmed by previously recorded history data or newly established upon the hospital admission. The patients were classified into three groups according to the duration of hypertension: A) up to 5 years, B) 6 to 10 years, C) 11 and more years. The intensity of hypertension was determined using mean systolic (SV) and diastolic (DV) val-ues of arterial blood pressure (BP). After repeated measure menu all patients were divided into four stages of hypertension: mild (BP 140-159 mm Hg SV/90-95 mm Hg Due, moderate (BP 160-179 mm Hg SV/100-109 mm Hg Due, severe (BP 180-209 mm Hg SV/110-119 mm Hg D~ and very severe(BP >210 mm Hg SV/> 120 mm Hg Due. The diagnosis of stroke was confirmed in most of the cases by the brain computerized tomography scan, and in some deceased pa-tients by pathoanatomical findings. In our subject group (n = 527 we found 429 patients to have an ischemic stroke (81.4%), 83 of them had an intracerebral hemorrhage (15.7%) and 15 paxients had a subarachnoid hemorrhage (2.9%). Hypertension was found to exist in about 77.696 of all the patients; within the stroke subtype groups patients with intracerebral hemorrhage had a higher proportion of hypertension than the ischemic stroke patients (91.6% vs. 74.6%). In 75 stroke patients hypertension was discovered for the first time after their hospitalization. Patients who had suffered from hypertension 11 and more years had a significantly greater frequency of stroke than patients with a duration of hypertension up to 5 years (?2 123. 6, p < 0.01 ) or 6 to 10 years ?292. 7, p < 0.01 ) . In the group of ischemic strokes, patients with mild and moderate stages of hypertension were significantly more represented than those with more severe stages of hypertension (?2 -84.1, p < 0.01). Patients with combined severe and very se-vere stage of hypertension slightly, but insignificantly, pre-vailed in the group of brain hemorrhages. There was no difference in sex distribution of total stroke cases, but a tendency of more frequent occurrence of subarachnoid hem-orrhage cases was noticed in female patients with hyperten-sion. Results of the study confirm that hyper-tension is the major risk factor for both ischemic and hemor-rhagic stroke in the population of Osijek, Croatia It appears that duration of hypertension had more important effect on stroke occurrence than its intensity. Thus early detection and adequate treatment of the mild to moderate hypertension should reduce a risk of stroke in the affected population.

hypertension; stroke; risk factors

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