Hypertension as Risk Factor of Poor Functional Outcome in Primary Ischemic Stroke Patients

https://doi.org/10.22146/ahj.v4i1.62783

Siti Aisyah Affiati(1*), Astuti Prodjohardjono(2), Abdul Gofir(3), Probosuseno Probosuseno(4), Noor Alia Susanti(5), Sri Sutarni(6), Ismail Setyopranoto(7)

(1) Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
(2) Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
(3) Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
(4) Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
(5) Neurology Research Office, Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
(6) Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
(7) Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
(*) Corresponding Author

Abstract


Survival rate of ischemic stroke has been improving which increases long-term disability in consequences.  GBD 2017 shows stroke as the third most common cause of morbidity. Hypertension is the most common risk factor for ischemic stroke incidence and affecting long-term functional outcome. Therefore, hypertension control in ischemic stroke is expected to improve functional outcome and quality of life. Therefore, this study was conducted to know the role of hypertension as risk factor of poor functional outcome in primary ischemic stroke patients. Study was conducted by observational retrospective cohort from May 2018 until April 2019 in 7 hospitals in D.I. Yogyakarta. Functional outcome of primary ischemic stroke patients was assessed by physician at day 30 by using Barthel Index. Bivariate analysis was analyzed by using Chi-Square with 95% CI and p-value <0.05 indicated statistical significance. Based on the study, there were increased risk for having dependent functional outcome in hypertension (RR=1.12, 95% CI=0.74-1.69), diabetes mellitus (RR=1.041, 95% CI=0.71-1.53) but these results were not statistically significant (p>0.05). From the study it can be concluded that hypertension is one of the most common risk factors of stroke but hypertension has no role in predicting functional outcome.  However, hypertension increases risk for having poor functional outcome in ischemic stroke patients.

Keywords


Ischemic Stroke; Hypertension; Risk Factor; Poor Functional Outcome; Barthel Index

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References

Feigin VL, Krishnamurthi R V, Parmar P, Norrving B, Mensah GA, Bennett DA, et al. Update on the Global Burden of Ischemic and Hemorrhagic Stroke in 1990-2013: The GBD 2013 Study. Neuroepidemiology. 2015/10/28. 2015;45(3):161–76. DOI:10.1159/000441085

Metrics GH. Erratum: Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017 (The Lancet (2018). Lancet. 2019;393(10190):e44. DOI:10.1016/S0140-6736(19)31047-5

Kementerian Kesehatan RI Badan Penelitian dan Pengembangan. Hasil Utama Riset Kesehatan Dasar [Internet]. Kementrian Kesehatan Republik Indonesia. 2018. p. 1–100. Available from:http://www.depkes.go.id/resources/download/info-terkini/hasil-riskesdas-2018.pdf

Dinas Kesehatan D.I.Yogyakarta. Profil Kesehatan Provinsi Daerah Istimewa Yogyakarta Tahun 2017 [Internet]. Dinas Kesehatan D.I.Yogyakarta. 2017. Available from:http://www.depkes.go.id/resources/download/profil/PROFIL_KES_PROVINSI_2017/14_DIY_2017.pdf

Rajsic S, Gothe H, Borba HH, Sroczynski G, Vujicic J, Toell T, et al. Economic burden of stroke: a systematic review on post-stroke care. Eur J Heal Econ. 2019 Feb 16;20(1):107–34. DOI:10.1007/s10198-018-0984-0

Schulc E, Pallauf M, Mueller G, Wildbahner T, Them C. Is the Barthel Index an Adequate Assessment Tool for Identifying a Risk Group in Elderly People Living at Home? Int J Nurs Clin Pract. 2015;2(1). DOI:10.15344/2394-4978/2015/140

Yudiarto F, Machfoed M, Darwin A, Ong A, Karyana M, Siswanto -. Indonesia Stroke Registry (S12.003) [Internet]. Vol. 82, Neurology. 2014. p. S12.003. Available from:http://n.neurology.org/content/82/10_Supplement/S12.003.abstract

Setyopranoto I, Bayuangga HF, Panggabean AS, Alifaningdyah S, Lazuardi L, Dewi FST, et al. Prevalence of stroke and associated risk factors in sleman district of Yogyakarta Special Region, Indonesia. Stroke Res Treat. 2019;2019. DOI:10.1155/2019/2642458

Ishitsuka K, Kamouchi M, Hata J, Fukuda K, Matsuo R, Kuroda J, et al. High Blood Pressure After Acute Ischemic Stroke Is Associated With Poor Clinical Outcomes. Hypertension. 2014 Jan;63(1):54–60. DOI:10.1161/HYPERTENSIONAHA.113.02189

Kusumaningsih W, Rachmayanti S, Werdhani RA. Relationship between risk factors and activities of daily living using modified Shah Barthel Index in stroke patients. J Phys Conf Ser. 2017;884(1). DOI:10.1088/1742-6596/884/1/012151

Nakibuuka J, Sajatovic M, Nankabirwa J, Ssendikadiwa C, Furlan AJ, Katabira E, et al. Early mortality and functional outcome after acute stroke in Uganda: prospective study with 30 day follow-up. Springerplus. 2015 Dec 25;4(1):450. DOI:10.1186/s40064-015-1252-8

El Assar M, Angulo J, Vallejo S, Peiró C, Sánchez-Ferrer CF, Rodríguez-Mañas L. Mechanisms Involved in the Aging-Induced Vascular Dysfunction. Front Physiol. 2012;3. DOI:10.3389/fphys.2012.00132

Bindawas SM, Vennu V, Mawajdeh H, Alhaidary H. Functional outcomes by age after inpatient stroke rehabilitation in Saudi Arabia. Clin Interv Aging. 2017 Oct;Volume 12:1791–7. DOI:10.2147/CIA.S145402

Wang Y, Dai Y, Zheng J, Xie Y, Guo R, Guo X, et al. Sex difference in the incidence of stroke and its corresponding influence factors: results from a follow-up 8.4 years of rural China hypertensive prospective cohort study. Lipids Health Dis. 2019 Dec 25;18(1):72. DOI:10.1186/s12944-019-1010-y

Fairweather D. Sex Differences in Inflammation during Atherosclerosis. Clin Med Insights Cardiol. 2014 Jan 19;8s3:CMC.S17068. DOI:10.4137/CMC.S17068

Zhang G, Li C, Zhu N, Chen Y, Yu Q, Liu E, et al. Sex differences in the formation of atherosclerosis lesion in apoE-/-mice and the effect of 17β-estrodiol on protein S-nitrosylation. Biomed Pharmacother. 2018 Mar;99:1014–21. DOI:10.1016/j.biopha.2018.01.145

Feigin VL. Global, Regional, and Country-Specific Lifetime Risks of Stroke, 1990 and 2016. N Engl J Med. 2018 Dec 20;379(25):2429–37. DOI:10.1056/NEJMoa1804492

Gall SL, Tran PL, Martin K, Blizzard L, Srikanth V. Sex Differences in Long-Term Outcomes After Stroke. Stroke. 2012 Jul;43(7):1982–7. DOI:10.1161/STROKEAHA.111.632547

Banerjee C, Chimowitz MI. Stroke Caused by Atherosclerosis of the Major Intracranial Arteries. Circ Res. 2017 Feb 3;120(3):502–13. DOI:10.1161/CIRCRESAHA.116.308441

Boehme AK, Esenwa C, Elkind MSV. Stroke Risk Factors, Genetics, and Prevention. Circ Res. 2017 Feb 3;120(3):472–95. DOI:10.1161/CIRCRESAHA.116.308398

Chen R, Ovbiagele B, Feng W. Diabetes and Stroke: Epidemiology, Pathophysiology, Pharmaceuticals and Outcomes. Am J Med Sci. 2016 Apr;351(4):380–6. DOI:10.1016/j.amjms.2016.01.011

Iadecola C, Davisson RL. Hypertension and Cerebrovascular Dysfunction. Cell Metab. 2008 Jun;7(6):476–84. DOI:10.1016/j.cmet.2008.03.010

Oh MY, Ko SB, Lee SH, Kim C, Ryu WS, Kim CH, et al. Association between metabolic syndrome and functional outcome in patients with acute ischaemic stroke. Eur J Neurol. 2014 Jan;21(1):177–9. DOI:10.1111/ene.12128



DOI: https://doi.org/10.22146/ahj.v4i1.62783

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