ArticleJournal of the neurological sciences2020
Frequency and factors linked to refractory hypertension among stroke survivors in Ghana.
Article in Journal of the neurological sciences, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Refractory Hypertension: a Narrative Systematic Review with Emphasis on Prognosis.Current hypertension reports · 2022Pooled it
- Stroke in Ghana: A Situational Analysis.Stroke research and treatment · 2025Review
- Review
- Determinants of visit-to-visit systolic blood pressure variability among Ghanaians with hypertension and diabetes mellitus.Ghana medical journal · 2023Article
- Promise of Physiological Profiling to Prevent Stroke in People of African Ancestry: Prototyping Ghana.Current neurology and neuroscience reports · 2022Review
- Key determinants of long-term post-stroke mortality in Ghana.Journal of the neurological sciences · 2022Article
- Stroke in Africa: profile, progress, prospects and priorities.Nature reviews. Neurology · 2021Review
- Influence of age on links between major modifiable risk factors and stroke occurrence in West Africa.Journal of the neurological sciences · 2021Article
- Factors associated with incidence of stroke and heart failure among people living with HIV in Ghana: Evaluating Vascular Event Risk while on Long-Term Antiretroviral Suppressive Therapy (EVERLAST) Study.Journal of clinical hypertension (Greenwich, Conn.) · 2021Article
- Atherosclerotic event risk and risk reduction therapies among Ghanaian hemorrhagic stroke survivors.Journal of the neurological sciences · 2021Observational
- Apparent Treatment Resistant Hypertension Among Stroke Survivors in Ghana.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2020Article
- Antecedent febrile illness and occurrence of stroke in West Africa: The SIREN study.Journal of the neurological sciences · 2020Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundRefractory hypertension (RfH) is a rare, severe phenotype of resistant hypertension, linked to higher risk of adverse cardiovascular outcomes. Little is known about the association of RfH with stroke type and subtype.
objectiveTo determine the prevalence and predictors of RfH among stroke survivors in Ghana.
methodsWe interrogated the dataset of a prospectively collected registry of hypertensive patients seen between July 2015 and June 2019, at five hospitals in Ghana. We compared stroke survivors to stroke-free controls. Clinic-based blood pressure was measured using a standardized protocol and antihypertensive medications were assessed via review of medical records and inspection of pills. Refractory hypertension was defined as office BP ≥140/90 mmHg on ≥5 classes of antihypertensive medications. Multivariate logistic regression models were constructed to assess factors associated with RfH.
resultsOf 3927 hypertensive patients (1169 stroke survivors, 2758 controls), 86 had RfH for an overall prevalence of 2.2% (95% CI: 1.8-2.7%). Among patients with RfH, 5.8% (4.5-7.3%) were stroke survivors vs. 0.7% (0.4-1.0%) were stroke-free (p < .0001). Adjusted odds ratio (95% CI) for factors associated with RfH were being male (1.81, 1.15-2.85), age < 60 years (2.64, 1.59-4.40), chronic kidney disease (2.09, 1.21-3.60), and known stroke (7.53, 4.35-13.04). RfH was associated with intracerebral hemorrhage, (11.43, 5.65-23.14), ischemic stroke (9.76, 5.47-17.42), lacunar stroke (13.58, 6.45-28.61), and non-lacunar ischemic stroke (3.67, 1.04-13.02).
conclusionPresence of RfH is significantly accentuated among stroke survivors. Intensified efforts are warranted to identify and aggressively address barriers to control in these patients to avert subsequent vascular events.
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