We sincerely thank Dr. Kawada for his interest in our study titled ‘Incident stroke
among Ghanaians with hypertension and diabetes: a multicenter, prospective study’.
The aim of our study [
[1]
] was to assess the rates and determinants of incident stroke among a prospective,
hospital-based Ghanaian cohort with hypertension and or type 2 diabetes mellitus.
In this regard, our study was not designed to “evaluate the risk of hypertension and
diabetes for incident stroke” as specified by our correspondents. Rather, we sought
to identify factors that increased the propensity for incident stroke among individuals
who already had hypertension or diabetes. We found that physical inactivity and previous
history of cigarette smoking were independently associated with stroke occurrence
in this cohort. Stroke type information was not available, hence it was not possible
to isolate the effect of risk factors for the primary ischemic or hemorrhagic stroke
types which was recognized as a study limitation. We also accounted for sex in our
model and found that although male sex was associated with a heightened risk of stroke
occurrence with an unadjusted odds ratio of 2.10 (95% CI of 1.21–3.64), this effect
size was attenuated into non-significance in our adjusted models. We found in sensitivity
analysis that stage II hypertension was also independently associated with stroke
occurrence. Indeed further re-analysis of this cohort has also shown that renal impairment
is also associated with incident stroke occurrence [
[2]
].Keywords
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References
- Incident stroke among Ghanaians with hypertension and diabetes: a multicenter, prospective cohort study.J. Neurol. Sci. 2018; 395: 17-24
- Estimated glomerular filtration rate predicts incident stroke among Ghanaians with diabetes and hypertension.J. Neurol. Sci. 2018; 396: 140-147
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- Dominant modifiable risk factors for stroke in Ghana and Nigeria (SIREN): a case-control study.Lancet Glob. Health. 2018; 6: e436-e446
Sarfo FS, Ovbiagele B, Gebregziabher M, Wahab K, Akinyemi R, Akpalu A, et al. Stroke among young West Africans: evidence from the SIREN (Stroke Investigative Research and Educational Network) large multisite case-control study.
- One-year rates and determinants of post-stroke systolic blood pressure control among Ghanaians.J. Stroke Cerebrovasc. Dis. 2017; 26: 78-86
- PINGS (Phone-based intervention under Nurse Guidance after Stroke): interim results of a pilot randomized controlled trial.Stroke. 2018; 49: 236-239
- Phone-based intervention for blood pressure control among Ghanaian stroke survivors: a pilot randomized controlled trial.Int. J. Stroke. 2018; 1747493018816423 ([Epub ahead of print] PMID: 30465630)https://doi.org/10.1177/1747493018816423
- Trends in stroke admission and mortality rates from 1983 to 2013 in Central Ghana.J. Neurol. Sci. 2016; 363: 217-224
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Article Info
Publication History
Published online: December 12, 2018
Accepted:
December 12,
2018
Received:
December 6,
2018
Identification
Copyright
© 2018 Published by Elsevier B.V.
