Mapoure NY¹, Ayeah CM¹, Ossou-Nguiet PM², Gnonlonfoun Dieu Donné³, Adoukonou Thierry⁴, Assogba Komi⁵, Njamnshi Alfred K⁶

Authors’ affiliations

1. Unité de Neurologie, Hôpital Général de Douala, Université de Douala, Cameroun
2. Université de Douala, Cameroun
3. Service de Neurologie du CHU de Brazzaville, Congo
4. Service de Neurologie du CHDU de Parakou, Bénin
5. Service de Neurologie du CHU Campus de Lomé, Togo
6. Service de Neurologie, Université de Yaoundé I, Cameroun

Corresponding author : Pr Mapoure Njankouo Y., Email : Cette adresse e-mail est protégée contre les robots spammeurs. Vous devez activer le JavaScript pour la visualiser. , Tél : 00237 696 96 37 47

Abstract

Background: Stroke is a leading cause of mortality and morbidity globally, but more so in low- and middle- income countries. But very little is known on the prognostic role of HTN and DM in acute stroke patients (ASP).

Objective:  To evaluate the impact of HTN and DM on the clinical profile and outcome of stroke patients admitted at the Douala General Hospital (DGH).

Methods: This was a hospital-based prospective cohort study which included all consenting ASPsubdivided into four groups; patients with DM plus HTN, HTN only, DM only and no DM and HTN. Survival analysis was performed using cox regression and Kaplan Meier analysis.

Results: Of the 898 ASP included, the mean age was 60.2±13.5 years. HTN only, DM only and HTN plus DM occurred in 55.5%, 3.3% and 22.5% respectively while 18.7% of stroke patients had no HTN and DM. Mortality rate was similar in all four groups: 24.3%, 16.7%, 23.3% and 21.4% in patients respectively (p=0.718). There was no significant difference in the survival rate in all four study groups (Log Rank test, p=0.758). All four groups had similar of dying during hospitalization in the acute phase of stroke; HTN only [OR = 1.025 (95% CI of 0.703-1.495); p=0.897], DM only [OR = 0.633 (95% CI of 0.248-1.617); p=0.633] and HTN plus DM [OR = 0.993 (95% CI of 0.639-1.544); p=0.977].

Conclusion: Mortality in hypertensive stroke patients with DM is similar to those without DM. It is therefore important to equally focus on the primary prevention of HTN and DM in Sub-Saharan Africa.

Keywords: Diabetes Mellitus; Hypertension; Outcome; Sub-Saharan Africa