Factors Linked to Chronic Kidney Disease Among Stroke Survivors in Ghana

Agyei, Martin; Ogyefo, Isaac Nana; Opare-Addo, Priscilla Abrafi; Ovbiagele, Bruce

doi:10.1016/j.jstrokecerebrovasdis.2021.105720

Cited by 4 publications

(1 citation statement)

References 26 publications

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“…Chronic kidney disease is quite prevalent among Ghanaians. 34,35 Indeed, among Ghanaians with diabetes and hypertension, there is a gradient in the prevalence of CKD from 28.5% among those with hypertension and diabetes to 26.3% among those with hypertension only and 16.1% among those with diabetes only. 34 With the progressive decline in renal function, two distinct pathologic types of vascular calcifications ensue, i.e.…”

Section: Discussionmentioning

confidence: 99%

Determinants of visit-to-visit systolic blood pressure variability among Ghanaians with hypertension and diabetes mellitus

Ayisi-Boateng

Nguah

Sarfo‐Kantanka

et al. 2023

gmj

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Objective: To identify the determinants of systolic blood pressure variability (SBPV) among Ghanaians.Design: We undertook a secondary analysis of data collected in a prospective studySetting: The study involved patients with hypertension and or diabetes receiving care in five hospitals in GhanaMain outcome measures: We assessed determinants of SBPV among 2,785 Ghanaian patients. We calculated the standard deviation (SD) of systolic BP recordings of 3 to 10 visits per patient over 18 months as a measure of SBPV. A multivariate linear regression analysis was fitted to identify factors independently associated with risk visit-to-visit SBP standard deviation.Results: The mean SD of individual patient visit-to-visit SBP overall was 14.8± 6.3 mm Hg. Those with hypertension and diabetes had the highest SD of 15.4 ±6.2 mm Hg followed by 15.2 ±6.5 mm Hg among those with hypertension only and then 12.0 ± 5.2 mm Hg among those with diabetes only, p<0.0001. Factors independently associated with SBPV with adjusted ß coefficients (95% CI) included age: 0.06 (0.03 – 0.08) for each year rise in age, eGFR -0.03 (-0.05 - -0.02) for each ml/min rise, low monthly income of <210 Ghana cedis 1.45 (0.43-2.46), and secondary level of education -1.10 (-1.69, -0.50). Antihypertensive classes were associated with SBPV, the strongest associations being hydralazine 2.35 (0.03 – 4.68) and Methyldopa 3.08 (2.39 – 3.77).Conclusion: Several socio-demographic and clinical factors are associated with SBPV. Future studies should assess the contribution of SBPV to CVD outcomes among indigenous Africans and identify actionable targets.

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Section: Discussionmentioning

confidence: 99%

Determinants of visit-to-visit systolic blood pressure variability among Ghanaians with hypertension and diabetes mellitus

Ayisi-Boateng

Nguah

Sarfo‐Kantanka

et al. 2023

gmj

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Younger age of stroke in low‐middle income countries is related to healthcare access and quality

Rahbar

Medrano

Diaz-Garelli³

et al. 2022

Ann Clin Transl Neurol

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Stroke is the second leading cause of mortality globally with higher burden and younger age in low‐middle income countries (LMICs) than high‐income countries (HICs). However, it is unclear to what extent differences in healthcare access and quality (HAQ) and prevalence of risk factors between LMICs and HICs contribute to younger age of stroke in LMICs. In this systematic review, we conducted meta‐analysis of 67 articles and compared the mean age of stroke between LMICs and HICs, before and after adjusting for HAQ index. We also compared the prevalence of main stroke risk factors between HICs and LMICs. The unadjusted mean age of stroke in LMICs was significantly lower than HICs (63.1 vs. 68.6), regardless of gender (63.9 vs. 66.6 among men, and 65.6 vs. 70.7 among women) and whether data were collected in population‐ (64.7 vs. 69.5) or hospital‐based (62.6 vs. 65.9) studies (all p < 0.01). However, after adjusting for HAQ index, the difference in the mean age of stroke between LMICs and HICs was not significant (p ≥ 0.10), except among women (p = 0.048). In addition, while the median prevalence of hypertension in LMICs was 23.4% higher than HICs, the prevalence of all other risk factors was lower in LMICs than HICs. Our findings suggest a much larger contribution of HAQ to the younger mean age of stroke in LMICs, as compared with other potential factors. Additional studies on stroke care quality and accessibility are needed in LMICs.

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Influence of age on links between major modifiable risk factors and stroke occurrence in West Africa

Akpa

Ovbiagele

Akpalu

et al. 2021

Journal of the Neurological Sciences

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Factors Linked to Chronic Kidney Disease Among Stroke Survivors in Ghana

Cited by 4 publications

References 26 publications

Determinants of visit-to-visit systolic blood pressure variability among Ghanaians with hypertension and diabetes mellitus

Determinants of visit-to-visit systolic blood pressure variability among Ghanaians with hypertension and diabetes mellitus

Younger age of stroke in low‐middle income countries is related to healthcare access and quality

Influence of age on links between major modifiable risk factors and stroke occurrence in West Africa

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