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Low blood pressure levels & incident stroke risk among elderly Ghanaians with hypertension

Fred Stephen Sarfo1, Linda Meta Mobula2, Titus Adade3

  • 1Department of Medicine, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana; Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.

Journal of the Neurological Sciences
|March 16, 2020
PubMed

Insights

Lowering blood pressure (BP) below 120/80 mmHg in elderly Ghanaians with hypertension showed a reduced risk of stroke. Further trials are recommended to confirm these findings in African populations.

Area of Science:

  • Cardiology
  • Neurology
  • Public Health

Background:

  • Clinical trials suggest intensive blood pressure (BP) lowering reduces stroke risk in the elderly.
  • Real-world data on this practice, particularly in African populations, is limited.

Purpose of the Study:

  • To evaluate BP control rates and their determinants in elderly Ghanaians with hypertension.
  • To investigate if a lower BP target (<120/80 mmHg) is associated with reduced incident stroke risk.

Main Methods:

  • Retrospective analysis of prospectively collected data from a cohort study in 5 Ghanaian hospitals.
  • BP control defined by JNC-8 guidelines (<150/90 mmHg for >60 years, <140/90 mmHg for diabetes).
  • Incident stroke risk assessed over 18 months at BP cut-offs of <120/80, 120-159/80-99, and >160/100 mmHg.

Main Results:

  • 45.8% of 1365 elderly hypertensive participants had uncontrolled BP.
  • Uncontrolled BP was linked to more antihypertensive medications (aOR 1.45) and diabetes (aOR 2.56).
  • Stroke incidence was 0 events/100py for BP <120/80 mmHg, versus 1.98 and 2.46 events/100py for higher BP ranges.

Conclusions:

  • A lower BP target (<120/80 mmHg) in elderly Ghanaians with hypertension may be associated with a reduced risk of stroke.
  • Pragmatic trials are necessary to validate lower BP targets for stroke prevention in Africa.
Abstract

Keywords:
AfricaBP thresholdsElderlyStroke risk

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