World Journal of
Pharmaceutical and Life Sciences

EVALUATION OF STROKE PATIENTS’ PRIME AND CONTRIBUTORY RISK FACTORS FOR RECURRENT STROKE: AN IDENTIFICATION OF NEWER AREAS OF PHARMACEUTICAL CARE NEEDS TO AVOID FURTHER STROKE EPISODES

*Dr. John David Ohieku and Ibrahim Suleiman

ABSTRACT

Background: The determination of patients’ individual risk factors for transient ischaemic attack (TIA), stroke and recurrent stroke (RS) in hypertension with existing stroke is desirable in order to institute appropriate preventive measures and treatment monitoring approaches that will prevent recurrent stroke episodes. Objectives: The objectives of the study were to identify patient-focussed prime and contributory risk factors having the potential of causing recurrent stroke and to determine the number of such risk factors in individual patient. Methods: A total of 156 patients who have witnessed at least one episode of stroke were evaluated for prime risk factors for recurrent stroke. The most recent laboratory data were obtained from their folders during clinic visits and were used to evaluate individual’s total cardiovascular and non-cardiovascular risk factors burden for recurrent stroke. Results: The mean and the standard deviation of the study population irrespective of gender was 61.2 ± 10.78 years. The incidence of stroke peaked in patients in their sixth decades of life (51-60 year). The mean ages and standard deviations for male and female patients were 61.7 ± 11.2 years and 59.8 ± 9.77 years respectively. The incidence of stroke related illness is 1.89 higher in male than female. Time interval between hypertension diagnosis and development of stroke in most patients 66(42.3%) was 5-10 years with few patients 26(16.7%) developing stroke after 15 years post hypertension diagnosis. In 77(48.7%) patients only hypertension exist without co-morbid disease conditions while 79(51.3%) had various co-morbid conditions such as diabetes 24(15.4%), chronic kidney disease 20(12.8%), obesity 11(7.1%) and so on. The stroke related illnesses were TIA 25(21.2%), ischaemic stroke 83(53.2%), haemorrhagic stroke 15(9.6%), and recurrent stroke 33(26.2%). The risk factors identified ranges from 1-7 with a cumulative value of 621 and a risk factor average of 3.98. About 75(48.1%) patients have 1-3 different types of risks while 81(51.9%) have total risk factors ?4. prime risk factors identified in the study or considered high are smoking 15(9.6%), fasting blood sugar 14(19.7%), TIA 25(16.0%), uncontrolled blood pressure 133(85.3%). Other modifiable risk factors that may contribute to the development of recurrent strokes are low potassium level 11(8.3%), low packed cell volume 74(50.7%). Conclusion: Several vascular risk factors capable of triggering another stroke episode such as hypertension, hyperlipidaemia, current smoking, dyslipidaemia, low packed cell volume and some non-vascular risk factors including low potassium levels were still observed present in high proportions in most patients. This underscore the need to keenly monitor such individual’s health and drug therapy and institute appropriate individualized patient education and care in order to limit or prevent further episode of stroke.

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