ArticleJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association2020
Apparent Treatment Resistant Hypertension Among Stroke Survivors in Ghana.
Article in Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- A Systematic Review of the Burden of Stroke in Ghana.BioMed research international · 2024Pooled it
- Physiologic profiling using plasma renin activity and aldosterone on blood pressure control among Ghanaian stroke survivors: A pilot trial.Equity neuroscience · 2025Article
- Stroke occurrence by hypertension treatment status in Ghana and Nigeria: A case-control study.Journal of the neurological sciences · 2024Article
- 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
- Apparent Treatment-Resistant Hypertension Among Stroke Survivors: A Transcontinental Study Assessing Impact of Race and Geography.American journal of hypertension · 2022Article
- Key determinants of long-term post-stroke mortality in Ghana.Journal of the neurological sciences · 2022Article
- Influence of age on links between major modifiable risk factors and stroke occurrence in West Africa.Journal of the neurological sciences · 2021Article
- Atherosclerotic event risk and risk reduction therapies among Ghanaian hemorrhagic stroke survivors.Journal of the neurological sciences · 2021Observational
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Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
Abstract
background and purposeThere are limited data evaluating the characteristics of apparent treatment-resistant hypertension (aTRH) among stroke survivors in sub-Saharan Africa. We aimed to conduct a comparative analysis of the frequency and factors associated with aTRH among stroke survivors and stroke-free individuals with hypertension in Ghana.
methodsCross-sectional multicenter study involving five hospitals in Ghana conducted between July 2015 and June 2018. Clinic-based blood pressure was measured using a standardized protocol and antihypertensive medications assessed via review of medical records and inspection of pills. aTRH was defined as either office BP ≥140/90mmHg on ≥3 classes of antihypertensive medications or on ≥4 antihypertensive medications regardless of BP. Multivariate logistic regression models were constructed to assess for associations between aTRH and co-variates.
resultsMean age of stroke survivors (n=1,169) was 59.3±13.3 years vs 58.4±12.4 years among stroke-free hypertensives (n=2,758), p=0.06. Among stroke survivors on ≥4 antihypertensive medications 18.1% had BP on a target of <140/90 mmHg and only 8.7% had BP <130/80mmHg. Prevalence of aTRH was 45.3%(95% CI: 42.4-48.2) among stroke survivors and 19.9%(18.4-21.4) among stroke-free hypertensives, p<0.0001. All stroke types were associated with aTRH with adjusted odds ratio (95% CI): hemorrhagic stroke 4.56(3.34-6.23), sub-arachnoid hemorrhage 4.10(1.70-9.90), ischemic stroke 2.85(2.32-3.50), and untyped stroke 1.92(1.41-2.60). Other predictors of aTRH were age <60 years, receiving care at a tertiary facility, and diabetes mellitus.
conclusionsMost stroke survivors encountered in this multisite study in Ghana had resistant hypertension. Tailored interventions are needed to mitigate the risk of recurrent adverse cardiovascular events in these patients.
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