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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Apparent Treatment Resistant Hypertension Among Stroke Survivors in Ghana
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Apparent Treatment Resistant Hypertension Among Stroke Survivors in Ghana

机译：加纳中风幸存者中表观治疗抗性高血压

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Background and purpose: There 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. Methods: Cross-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. Results: Mean 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), subarachnoid 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. Conclusions: Most 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.
机译：背景和目的：评估撒哈拉以南非洲中风幸存者中表观治疗耐受性高血压（aTRH）特征的数据有限。我们旨在对加纳中风幸存者和无中风高血压患者中aTRH的发生率和相关因素进行对比分析。方法：2015年7月至2018年6月，对加纳五家医院进行了横断面多中心研究。临床血压测量采用标准化方案，抗高血压药物通过检查病历和药片进行评估。aTRH的定义是，无论血压是多少，服用>=3类抗高血压药物或服用>=4类抗高血压药物的办公室血压>=140/90mmHg。建立多变量逻辑回归模型来评估aTRH和协变量之间的相关性。结果：无卒中高血压患者（n=2758）中，卒中幸存者（n=1169）的平均年龄为59.3+/-13.3岁，而无卒中高血压患者（n=2758）的平均年龄为58.4+/-12.4岁，p=0.06。在服用>=4种抗高血压药物的中风幸存者中，18.1%的人血压低于140/90毫米汞柱，只有8.7%的人血压低于130/80毫米汞柱。脑卒中幸存者中aTRH的患病率为45.3%（95%CI:42.4-48.2），无脑卒中高血压患者中aTRH的患病率为19.9%（18.4-21.4），p<0.0001。所有卒中类型均与aTRH相关，校正优势比（95%CI）：出血性卒中4.56（3.34-6.23），蛛网膜下腔出血4.10（1.70-9.90），缺血性卒中2.85（2.32-3.50），非类型卒中1.92（1.41-2.60）。aTRH的其他预测因素包括年龄<60岁、在三级医疗机构接受治疗和糖尿病。结论：在加纳进行的这项多地点研究中，大多数中风幸存者患有顽固性高血压。需要有针对性的干预措施来降低这些患者反复发生心血管不良事件的风险。

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