Re - Appraisal of risk factors for stroke in Nigerian Africans - A prospective case - Control study

Stroke is one of the major challenges facing medicine with a frightening statistics of being the second leading cause of death and the leading cause of physical disability worldwide. Identification and management of risk factors remains the key to reducing morbidity and mortality from stroke. Eighty patients with clinical presentation of stroke were recruited consecutively from the Emergency Departments of the University Teaching Hospital and Specialist Hospital - both situated in Benin City, Nigeria. The patients were followed up for a two year period (June 2000 - June 2002) and risk factors analysis was done on all patients. The patients were compared with eighty age and sex matched subjects without stroke (controls). Hypertension remained the dominant risk factor with an odds ratio of 2.68 (95% CI 1.29 - 5.59). Diabetes mellitus independently conferred a risk of 3.23 (95% CI 1.09 - 5.71) and in combination with hypertension enhanced stroke risk (odds ratio 7.21; 95% CI 5.79 - 13.27; p<0.05). Cigarette smoking, obesity, atrial fibrillation and physical inactivity significantly increased stroke risk (p<0.05). On the other hand, dietary habits, alcohol consumption and serum cholesterol were not important risk factors in Nigerians. This study emphasized the significance of optimal blood pressure and glycemic control in stroke prevention. The message for all is to exercise, maintain a healthy weight, avoid smoking and monitor blood pressure and glucose levels regularly.