Stroke prevalence and associated factors among older patients with hypertension attending public healthcare facilities in Greater Kampala Metropolitan Area, Uganda

TL;DR

This study found that 18.3% of older patients with hypertension in Uganda had stroke, with factors like age and education level playing a role.

Contribution

The study identifies specific factors associated with stroke in older hypertensive patients in Uganda, a previously underexplored population.

Findings

The prevalence of stroke among older patients with hypertension was 18.3%.

Being aged 80 years and above and having health insurance were significantly associated with stroke.

High knowledge of stroke and receiving stroke-related health information were linked to increased stroke prevalence.

Abstract

Globally, stroke is one of the top three leading causes of death and disability. Although several stroke risk factors are modifiable, including hypertension, factors associated with stroke among older patients with hypertension in Uganda remain underexplored. This study assessed the prevalence and factors associated with stroke among older patients with hypertension in public healthcare facilities in the Greater Kampala Metropolitan Area, Uganda.

A cross-sectional study was conducted among 383 older patients with hypertension. Systematic sampling was used to recruit study participants, and STATA 15.0 was used for analysis. Descriptive statistics were used to present continuous variables, while frequencies and proportions were used to present categorical data. Bivariate analyses identified associations between independent variables and stroke. Multivariable analyses controlled for confounders. A modified Poisson regression analysis with robust standard errors estimated prevalence ratios.

Of the 383 respondents, 71.0% (272/383) were aged 60–69 years (mean age 66.8 ± 7.1), 80.9% (310/383) were female, and 42.8% (164/383) had a primary education level (1–7 years). About 31.9% (122/383) exercised regularly, 94.8% (363/383) consumed carbohydrates frequently, 5.2% (20/383) had ever smoked, and 42.0% (151/383) had ever consumed alcohol. The prevalence of stroke was 18.3% (70/383). The factors associated with stroke included being aged 80 years and above (APR = 2.68, 95% CI: 1.59–4.51), having 8–13 years of formal education (secondary education)(APR = 0.37, 95% CI: 0.14–0.98), possessing health insurance (APR = 3.34, 95% CI: 1.19–9.37), having high knowledge of stroke (APR = 24.72, 95% CI: 6.20–98.55), and receiving stroke-related health information (APR = 1.78, 95% CI: 1.05–3.02).

This study demonstrated a high prevalence of stroke among older patients with hypertension. Public health education and community outreach should be expanded to underserved populations, while age-specific hypertension management and affordable healthcare services are essential. Engaging men and leveraging stroke survivors as peer educators can further strengthen prevention efforts. Future research should explore barriers to prevention and develop tailored interventions for diverse populations

Figures