Predictors of ischemic versus hemorrhagic strokes in hypertensive patients.

OBJECTIVE

To identify the factors that predispose to ischemic versus hemorrhagic stroke in hypertensive patients.

DESIGN

Cohort study.

PLACE AND DURATION OF STUDY

The study was conducted at the Aga Khan University Hospital (AKUH), Karachi, from August 1999 to May 2001.

MATERIALS AND METHODS

All the hypertensive patients, who were registered in AKUH acute stroke outcome data base, over a period of 22 months, were identified and from this cohort the patients with first ever stroke were selected. The data regarding demographics, stroke type (ischemic vs. hemorrhagic), pre-existing medical problems, laboratory and radiological investigations was recorded and analyzed.

RESULTS

Five hundred and nineteen patients with either ischemic stroke or parenchymal hemorrhage were registered over a period of 22 months. Three hundred and forty-eight patients (67%) had hypertension and of these, 250 had first ever stroke at the time of admission. Presence of diabetes mellitus (OR: 3.76; CI:1.67-8.46) and ischemic heart disease (OR: 6.97; CI:1.57-30.98) were found to be independent predictors of ischemic strokes.

CONCLUSION

Presence of diabetes mellitus and ischemic heart disease predict ischemic stroke in a patient with hypertension.