Knowledge of stroke risk factors among Nigerians at high risk

Assessing the efficacy of an educational video on stroke knowledge in Lebanon: a single-arm interventional study

OBJECTIVE

This study aimed to assess the public's knowledge of stroke before and after viewing an educational video about stroke risk factors, preventive measures, and alarming signs.

METHODS

A single-arm interventional study was conducted in Lebanon using a 3-minute video-based education about stroke. A pre- and post-structured questionnaire compared the level of knowledge about stroke.

RESULTS

The study included 685 participants. Knowledge of stroke, risk factors, warning signs, treatment, and preventive measures significantly increased post-educational video sessions. A higher baseline knowledge score was associated with a family history of stroke (Beta = 1.76) and being a healthcare professional (Beta = 3.35). Participants between 25 and 34 years (Beta=-1.39) and those with a high risk of stroke (Beta=-1.03) were significantly associated with a lower knowledge score.

CONCLUSION

This study demonstrated the effectiveness of a video-based educational tool to raise awareness about stroke. Short, targeted audio-visual resources using lay language can convey health education messages and influence behavioral changes. The community can benefit from a large-scale educational campaign that targets different socio-economic statuses to enhance knowledge of stroke and save lives.

Cardiovascular Risk Awareness, Exercise Practices and Metabolic Outcomes among Patients with Diabetes Mellitus in Northern Nigeria: A Cross-sectional, Multicentre Study

BACKGROUND

Physical exercise helps to mitigate cardiovascular risks in people with diabetes mellitus (DM), but there are limited data in Nigeria. This study aimed to assess cardiovascular risk awareness, exercise practices and metabolic outcomes among Nigerians with diabetes.

MATERIALS AND METHODS

We conducted a cross-sectional study at five tertiary hospitals using questionnaire interviews and clinical assessments. Participants' knowledge of cardiovascular risk factors and knowledge of exercise were assessed on 12- and 5-item scores, while exercise practices were classed as adequate if performed regularly on 3 or more days weekly for a total of 150 min or more based on the American Diabetes Association recommendations. Mean body mass index (BMI), blood pressure (BP), fasting blood glucose, serum haemoglobin A1C (HbA1c), lipid profile, urea, creatinine and uric acid were then compared among participant groups.

RESULTS

We studied 426 participants with DM, 58.7% females. The mean age was 52.9 ± 13.1 years, with males significantly older than females (54.6 ± 12.2 vs. 51.8 ± 13.5 years; 95% confidence interval: 0.27-5.28, P = 0.03). The mean age at diabetes diagnosis was 44.8 ± 11.7 years, and the median duration of diabetes was 84 months. There was low knowledge of cardiovascular risk factors and low knowledge of exercise (mean scores of 2.94 and 2.31, respectively). Forty-three per cent of participants reported adequate exercise, which was significantly associated with younger age (P = 0.007), male gender (P = 0.001) and formal education (P = 0.021). Participants with adequate exercise had lower systolic BP and serum urea compared to those with inadequate exercise, but there were no significant differences in BMI, fasting glucose, HbA1c, serum lipids, creatinine or uric acid.

CONCLUSION

Participants had low knowledge of cardiovascular risks and the appropriate exercise practices for diabetes patients. There is a need for better patient education on diabetes self-care and exercise at clinic visits.

Prevalence and knowledge of modifiable cardiovascular diseases risk factors among vulnerable population in Central Tanzania

BACKGROUND

Cardiovascular diseases (CVDs) are the global public health problem which has been associated with increasing prevalence of modifiable CVDs risk factors. This study aimed to describe the prevalence and knowledge of modifiable CVDs risk factors among vulnerable population of Central Tanzania.

METHODS

A community-based cross-sectional study design was employed. A total of 749 participants were interviewed. The socio-demographic information and modifiable CVDs risk factors (behavioral and biological) were measured using a modified World Health Organization (WHO) STEPwise approach for chronic disease risk factor surveillance. Knowledge of modifiable CVDs risk factors was measured by comprehensive heart disease knowledge questionnaire. Descriptive statistics were used to describe the knowledge and prevalence of modifiable CVDs risk factors. Logistic regression analysis was used to determine the factors associated with adequate knowledge of CVDs risk factors.

RESULTS

The prevalence of béhavioral risk factors were; current smokers and alcohol consumers were 4.4% and 18.0% respectively, use of raw salt was 43.7%, consumption of fruit/vegetables < 5 days per week was 56.9%. The prevalence of Biological CVDs risk factors was as follows: Overall, 63.5% (33.3% overweight and 29.9% obese) were overweight or obese, 4.5% were diabetic and 43.4% were hypertensive. Only 35.4% of participants had adequate knowledge of CVDs risk factors. Being a male (AOR = 1.44, 95%CI = 1.01-2.06, p < .05), having primary education (AOR = 6.43, 95%CI = 2.39-17.36, p < .0001), being employed (AOR = 1.59, 95%CI = 1.00-2.52, p < .05), ever checked blood pressure (AOR = 0.59, 95%CI = 0.42-0.84, p < .001), family history of hypertension (AOR = 0.38, 95%CI = 0.25-0.57, p < .0001) determined adequate knowledge of CVDs risk factors.

CONCLUSIONS

This study has revealed a high prevalence of modifiable CVDs risk factors and low knowledge of CVDs risk factors. Community health promotion interventions to increase population knowledge of CVDs risk factors are recommended for the efficacious reduction of CVDs in the country.

Effect of a Nurse-Led Intervention on Knowledge of the Modifiable Risk Behaviors of Cardiovascular Disease: A Randomized Controlled Trial

Introduction

Cardiovascular disease (CVD) has disproportionately burdened the low- and middle-income countries where awareness and detection rates remain very low. Interventions directed to promote the community's awareness of CVD may help reduce the public's exposure to behavioral risk factors. However, the effectiveness of interventions implemented through a nurse on knowledge of the modifiable behavioral risk factors and preventive measures of CVD has not been determined in Kenya.

Objective

To establish the effect of a nurse-led intervention on knowledge of the modifiable risk behaviors of CVD in adults with metabolic syndrome (MetS) attending a mission-based hospital in Kenya.

Methods

A two-armed parallel-group randomized controlled trial design was conducted among 352 adults aged 18-64 years with MetS. The participants were recruited from a faith-based hospital in Nairobi, Kenya and randomly allocated to either a nurse-led lifestyle intervention or a control group. The intervention group received a comprehensive health education intervention using the World Health Organization (WHO) guideline recommendations for CVD control and prevention. Individuals in the control group were exposed to the usual CVD care according to hospital protocol. The duration of the intervention was 12 months. The primary outcome measure was a change in levels of knowledge on the modifiable risk factors and preventive measures of CVD. Outcome measures were assessed at baseline and at 15 months postintervention. Pre- and postintervention difference in the level of knowledge between the two groups was determined using the chi-square test of independence.

Results

The knowledge level of CVD risk factors and preventive measures was very low in both groups at baseline without significant difference. A significant improvement in the level of knowledge on CVD risk factors (78.2% vs. 30.4%, p < .001) and preventive measures (74.4% vs. 29.0%, p < .001) was observed in the intervention group relative to the control at the end-line.

Conclusions

The nurse-led lifestyle intervention significantly improved participants' level of knowledge on CVD risk factors and preventive measures. It is highly recommended that nurses incorporate routine health education interventions for patients with cardio-metabolic abnormalities.

Evaluation of stroke pre-hospital management in Lebanon from symptoms onset to hospital arrival and impact on patients' status at discharge: a pilot study

BACKGROUND

Hospital arrival time after acute ischemic stroke onset is the major factor limiting the eligibility of patients to receive intravenous thrombolysis. Shortening the prehospital delay is crucial to reducing morbidity and mortality for stroke patients. The study was conducted to investigate the factors that influence hospital arrival time after acute stroke onset in the Lebanese population and to assess the effect of the prehospital phase on patients' prognosis at discharge.

METHOD

A prospective cross-sectional study was performed in eleven hospitals from April to July 2021 including 100 patients having stroke symptoms or transient ischemic attack (TIA). Two questionnaires were used to collect data addressing patient management in the pre-hospital phase and the in-hospital phase. Descriptive and bivariate analyses were done to evaluate the potential associations between prognosis, pre-hospital characteristics, and other factors.

RESULTS

The patients' mean age was 70.36 ± 12.25 years, 43 (53.8%) of them were females, and 79 (85%) arrived within 3 hours after symptoms onset. Diabetic patients had a significant delay in hospital arrival compared with non-diabetics (27.0%vs.7.1%, p-value = 0.009). Moreover, 37 (75.5%) of school-level education patients arrived early at the hospital compared to 7 (100%) of university-level education (p-value = 0.009). The modified Rankin Scale (mRS) at discharge in patients with hemorrhagic stroke (10 (90%)) was worse than that in patients with ischemic stroke (38 (80%)) or TIA (3 (15%)) (p-value< 0.001).

CONCLUSION

The study findings make it imperative to raise awareness about stroke symptoms among the Lebanese population. Emergency Medical Services should be utilized appropriately in the transportation of stroke patients to achieve optimal patient outcomes.

Stroke Related Knowledge, Prevention Practices and Associated Factors Among Hypertensive Patients at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2021

Introduction

Stroke is a global health problem, causing significant morbidities and mortalities in both developing and developed countries. Patients living with chronic diseases like hypertension are at a high risk of stroke. Approximately 80% of strokes could be prevented with necessary preventive practices. There is scarce evidence in the preventive practices in Ethiopia, particularly in the study area. Therefore, this study aimed to assess knowledge and prevention practices related to stroke among hypertensive patients at the University of Gondar comprehensive specialized hospital, northwest Ethiopia.

Methods

An institution-based cross-sectional study was conducted among 393 hypertensive patients at the University of Gondar Comprehensive Specialized Hospital from May 1st to June 30th, 2021. The study participants were selected by a systematic random sampling technique. A semi-structured and interviewer-administered questionnaire was used to collect data. The data was entered into EPI Info version 7.2.1 and analyzed with SPSS version 23.0. Binary logistic regression analyses were undertaken to identify associated factors. The level of significance was determined using the adjusted odds ratio (AOR) with its 95% CI at a p-value of 0.05.

Results

Participants in this study had adequate knowledge of stroke and good prevention practices in 40.7% (95% CI: 35.9, 45.5) and 51.7% (95 CI: 46.8, 56.5) of cases, respectively. Attending secondary education and above 4.6 (95% CI: 2.08, 10.17), knowing someone who has had a stroke 13.17 (95% CI: 7.3, 23.77), and physical activity 4.05 (95% CI: 2.23, 7.36) were all significantly associated with adequate stroke knowledge. Furthermore, educational status (attending primary education 2.61 (95% CI: 1.44, 4.73) and secondary education and above 3.75 (95% CI: 1.99, 7.05), being an urban dweller 9.65 (95% CI: 5.04, 18.44), duration of hypertension 1.9 (95% CI: 1.15, 3.14), knowing someone with a stroke 2.27 (95% CI: 1.30, 3.93), and physical activity 1.76 (95% CI: 1.03, 3.01) were associated with good stroke prevention practices.

Conclusion

The proportion of participants with good-related knowledge and prevention practice is relatively good.

Public's Knowledge of Hypertension and its Associated Factors: A Cross-Sectional Study

Background:

Hypertension is a significant challenge for healthcare systems globally. It is estimated to cause 7.5 million deaths worldwide annually. Knowledge of hypertension plays a crucial role in behavioral changes required to prevent and manage the condition. This study aimed to assess the public's knowledge of hypertension’s risk factors, symptoms, complications, and treatment.

Methods:

This cross-sectional, descriptive, and exploratory study included a convenience sample of 723 Jordanian adults. The Hypertension Knowledge Test was used to measure the participants' knowledge of hypertension’s risk factors, symptoms, complications, and treatment.

Results:

The participants' mean score of total hypertension knowledge was 11.5 ±3.82 (52.2%), with 85.9% (n=621) having inadequate knowledge. Their mean scores for hypertension’s risk factors, symptoms, complications, and treatment were 7.45 ±2.35 (62.1%), 2.29 ±1.21 (45.8%), 1.38 ± 0.943 (46%), and 0.391 ± 0.603 (19.6%), respectively. Four factors were found to be significant predictors of participants' knowledge, such as age (p=0.002), education level (p<0.001), family history (p<0.001), and receiving hypertension-related information (p<0.001).

Conclusion:

The participants had inadequate knowledge regarding hypertension’s complications, risk factors, symptoms, and treatment. Public health education programs that focus on hypertension knowledge are required. Nurses and other healthcare providers should take the initiative in hypertension education. Strategic planning and designing of hypertension programs are required to fit the needs of the Jordanian public to enhance their knowledge of hypertension and related preventive and control measures.

Knowledge, Prevention Practice and Associated Factors of Stroke Among Hypertensive and Diabetic Patients - A Systematic Review

INTRODUCTION

Because of the inadequate level of public awareness of the disease, the incidence of stroke has been sharply rising. Eventually, due to the prehospital delay, many stroke cases could not be eligible for thrombolysis thereby poor rehabilitative outcome has been tremendously increased. Thus, this study aimed to review the level of knowledge, prevention practice, and associated factors of stroke among hypertensive and diabetic patients.

METHODS

A systematic review of primarily published articles (2010-2020) related to knowledge and prevention practices of stroke was performed by searching online electronic databases like PubMed, Google Scholar, Refseek, Science direct, ResearchGate, and manual Google search by using the keywords and MeSH terms. Studies conducted on knowledge and prevention practices amongst hypertensive and/or diabetic patients were included.

RESULTS

Out of 531 searched studies, 42 articles were identified to be reviewed. The reported overall knowledge of stroke was ranging from 4.4% to 79%. Knowledge to the signs/symptoms of stroke was 23.6% to 87%. However, 15% to 77% of subjects were also reported that they did not know any sign of stroke. The range of risk factor knowledge was 10.5% to 86.6%. The reported level of stroke prevention practice was 2.4% to 72% but physical activity and weight reduction practice were relatively low. Inadequate level of knowledge and prevention practice of stroke was related to elderly, female gender, uneducated, unmarried, rural residents, economically low, comorbidity and unemployed individuals.

CONCLUSION

The current finding revealed that the level of knowledge and prevention practice of stroke was inadequate. Hence, the finding highlights health educational programs should be planned as an important avenue to enhance stroke awareness among the high-risk populations.

Knowledge on Prevention of Stroke and Its Associated Factors Among Hypertensive Patients at Debre Tabor General Hospital: An Institution-Based Cross-Sectional Study

Introduction

Globally, stroke is the second leading cause of death. About 70% of strokes were occurring in low- and middle-income countries, and high blood pressure is the main risk factor of stroke due to its poor recognition of stroke prevention methods. Therefore, the study aimed to assess knowledge on stroke prevention and its associated factors among hypertensive patients at Debre-Tabor General Hospital, Northwest Ethiopia, 2020.

Methods

An institutional-based cross-sectional study was conducted in Debre-Tabor General Hospital from February 20 to March 20/2020. A systematic random sampling technique was used. Data were collected through an interviewer-administered questionnaire. Data were entered into Epi data version 4.2.0.0 and exported to SPSS version 25 for cleaning and analysis. A reliability test was done, and the Cronbach alpha coefficient value was 0.709. Bivariate and multivariable binary logistic regression analyses were done, and variables with a p-value of ≤0.05 in the multivariable analysis were considered as statistically significant at a 95% confidence interval.

Results

From 423 study participants, 410 of them responded completely and a response rate is 96.92%. Among the total respondents, 24.9% (95% CI: 20.7, 29.3) of participants had good knowledge of stroke prevention methods. Young age (AOR: 2.082; 95% CI (1.071, 4.049)), urban residence (AOR: 3.230; 95% CI (1.665, 6.267)), and having long followed-up duration (AOR: 3.015; 95% CI (1.870, 4.861)) were factors associated with good knowledge on stroke prevention methods.

Conclusion

This study revealed that participants had poor knowledge of stroke prevention. Young age, urban residence, and having long duration hypertension follow-up were predictors of good knowledge on stroke prevention. These findings have immense importance of different stakeholders that have responsibilities on the reduction of hypertension complications characteristically stroke. Further, it is chief for health-care providers for hypertension intervention activities.

Public knowledge of risk factors and warning signs for cardiovascular disease among young and middle-aged adults in rural Tanzania

Background

Improving cardiovascular health requires public knowledge and reduction of modifiable cardiovascular disease (CVD) risk factors. This study assessed knowledge of risk factors and warning signs for CVDs among young and middle-aged adults in Morogoro, Tanzania.

Methods

We conducted a community-based survey as part of cluster randomized controlled study of community health workers (CHWs) intervention for reduction of blood pressure among young and middle-aged adults in rural Morogoro. Information on socio-demographic characteristics, knowledge of risk factors and warning signs for CVDs was collected using an interviewer administered questionaire. Knowledge was assessed using open-ended questions followed by closed-ended questions. Descriptive statistics were used to describe knowledge of risk factors and warning signs. Logistic regression analysis was used to investigate factors associated with adequate knowledge of risk factors and warning signs for CVDs.

Results

Two-thirds (65.7%) of the participants had heard about CVDs. The main sources of information were mainly relatives/ neighbors (64.8%) and radio (53.0%). Only 28.3% of the participants reported health care providers as source of information about CVDs. More than half of the participants (52.4%) did not mention even one risk factor spontaneously while 55.2% were unable to mention any warning sign. When asked to select from a list, 6.9% were unable to correctly identify any risk factor whereas 11.8% could not correctly identify even a single warning sign. Quarter of participants (25.4%) had good knowledge score of risk factors, 17.5% had good knowledge score of warning signs and 16.3% had overall good knowledge of both risk factors and warning signs. Residing in Ulanga, having higher education level, having ever checked blood pressure and being overweight/obese predicted adequacy of knowledge score for both risk factors and warning signs.

Conclusion

Knowledge of risk factors and warning signs in this rural population of young and middle-aged adults was generally low. Health care providers were less likely to provide health education regarding risk factors and warning signs for CVDs. Health promotion interventions to increase population knowledge of risk factors and warning signs should be implemented for successful reduction of CVDs in Tanzania.

Knowledge, attitudes, and preventative practices regarding ischemic heart disease among emergency department patients in northern Tanzania

OBJECTIVES

The objective of this study is to increase understanding of knowledge, attitudes, and preventative practices regarding ischemic heart disease (IHD) in sub-Saharan Africa in order to develop patient-centered interventions to improve care and outcomes.

STUDY DESIGN

This is a prospective observational study.

METHODS

Adult patients presenting with chest pain or shortness of breath to an emergency department in northern Tanzania were enrolled. A questionnaire was adapted from existing knowledge attitude and practice surveys regarding cardiovascular disease and the WHO STEPS instrument. Individual five-year risk of cardiovascular event was determined by validated models based on age, sex, systolic blood pressure, body mass index, diabetes, and smoking status. An IHD knowledge score was calculated by giving one point for each correct response to the knowledge-related items, with a maximum score of 10. Associations between IHD knowledge and patient characteristics were assessed by Welch's t-test.

RESULTS

A total of 349 patients were enrolled, with median interquartile range (IQR) age 60 (45, 72) years. Of participants, 259 (74.2%) had hypertension, and 228 (65.3%) had greater than 10% five-year risk of cardiovascular event. The mean (SD) knowledge score was 4.8 (3.3). The majority of respondents (224, 64.2%) recognized obesity as a risk factor for heart attack, while a minority (34, 9.7%) knew that a daily aspirin could reduce the risk of cardiovascular event. Greater IHD knowledge was associated with younger age (P = 0.045) and higher levels of education (P < 0.001) but not higher risk of cardiovascular disease (P = 0.123). Most respondents expressed a willingness to diet to improve their health (322, 92.3%) and a preference for treatment from a physician rather than a traditional healer for a heart attack (321, 92.0%). A minority of patients reported exercising regularly (88, 25.2%) or seeing a doctor routinely for checkups (100, 28.7%).

CONCLUSIONS

High-risk emergency department patients in northern Tanzania have moderate knowledge regarding IHD but do not consistently engage in healthy preventive practices. Patient-centered interventions are needed to improve IHD knowledge and practices in high-risk populations.

Heart Attack and Stroke Symptoms Knowledge of Native Hawaiians and Pacific Islanders in the United States: Findings From the National Health Interview Survey

Native Hawaiians and other Pacific Islanders (NHPI) suffer disproportionate rates of death from heart attack and stroke; however, little is known about NHPI heart attack and stroke symptoms knowledge. We used multivariable logistic regression to examine associations between heart attack and stroke symptoms knowledge and electronic health (eHealth) use, education, engaging in health risk behaviors, and having an at-risk diagnosis or a past heart attack and/or stroke. The analytic sample included 2,172 NHPI adults responding to the 2014 NHPI-National Health Interview Survey. NHPI reported moderate to high levels of heart attack and stroke symptoms knowledge. NHPI with an at-risk diagnosis were significantly more likely to know three of five heart attack symptoms. Engaging in health risk behaviors increased the odds of knowing one heart attack symptom. Neither a prior heart attack nor a prior stroke increased the likelihood of recognizing most symptoms of heart attack or stroke. eHealth use was associated with increased likelihood for knowing heart attack and stroke symptoms. The findings of this study can be used to inform interventions that support the Healthy People 2020 goals to increase the proportion of adults who are aware of the symptoms of heart attack and stroke and to reduce heart attack and stroke disparities.

Knowledge, attitudes and practices of West Africans on genetic studies of stroke: Evidence from the SIREN Study

BACKGROUND

It is crucial to assess genomic literacy related to stroke among Africans in preparation for the ethical, legal and societal implications of the genetic revolution which has begun in Africa.

OBJECTIVE

To assess the knowledge, attitudes and practices (KAP) of West Africans about stroke genetic studies.

METHODS

A comparative cross-sectional study was conducted among stroke patients and stroke-free controls recruited across 15 sites in Ghana and Nigeria. Participants' knowledge of heritability of stroke, willingness to undergo genetic testing and perception of the potential benefits of stroke genetic research were assessed using interviewer-administered questionnaire. Descriptive, frequency distribution and multiple regression analyses were performed.

RESULTS

Only 49% of 2029 stroke patients and 57% of 2603 stroke-free individuals knew that stroke was a heritable disorder. Among those who knew, 90% were willing to undergo genetic testing. Knowledge of stroke heritability was associated with having at least post-secondary education (OR 1.51, 1.25-1.81) and a family history of stroke (OR 1.20, 1.03-1.39) while Islamic religion (OR=0.82, CI: 0.72-0.94), being currently unmarried (OR = 0.81, CI: 0.70-0.92), and alcohol use (OR = 0.78, CI: 0.67-0.91) were associated with lower odds of awareness of stroke as a heritable disorder. Willingness to undergo genetic testing for stroke was associated with having a family history of stroke (OR 1.34, 1.03-1.74) but inversely associated with a medical history of high blood pressure (OR = 0.79, 0.65-0.96).

CONCLUSION

To further improve knowledge of stroke heritability and willingness to embrace genetic testing for stroke, individuals with less formal education, history of high blood pressure and no family history of stroke require targeted interventions.

The relationship between the level of knowledge in the field of pro-health procedures and the quality of life in people after stroke

Introduction: Nowadays, international organisations such as WHO, UNICEF and UNFPA support a holistic approach towards an individual, aimed at solving life problems, which is missing from educational prevention programmes. At first, the level of knowledge in the individuals should be defined in order to adjust the information concerning an ailment to educational needs. The overall and neurological state of the individual affected by stroke very frequently does not allow to convey much knowledge. Knowledge on stroke results in decreased incidence, which explains the necessity to raise awareness of risk factors for stroke. The aim: The aim of the research was to establish a connection between the level of knowledge of the ailment in people affected by stroke and their quality of life. Material and methods: The research included 279 people after stroke. Their quality of life was assessed using a shortened version of the WHOQOL-Bref questionnaire. In order to assess the level of knowledge of health-supporting actions after stroke, an indicator of knowledge was created. Results: The strongest dependence in the somatic (DOM1), social (DOM3) and environmental fields (DOM4) was observed in the group of people between 13 and 24 months after falling ill. The strongest dependence in the psychological field (DOM2) was observed in the group of people between 6 and 12 months after the incident. Conclusion: The level of health-supporting knowledge in people affected by stroke is not satisfactory. A higher level of knowledge results in a higher quality of life.

Knowledge and awareness of and perception towards cardiovascular disease risk in sub-Saharan Africa: A systematic review

INTRODUCTION

Cardiovascular diseases (CVDs) are the most common cause of non-communicable disease mortality in sub-Saharan African (SSA) countries. Gaps in knowledge of CVD conditions and their risk factors are important barriers in effective prevention and treatment. Yet, evidence on the awareness and knowledge level of CVD and associated risk factors among populations of SSA is scarce. This review aimed to synthesize available evidence of the level of knowledge of and perceptions towards CVDs and risk factors in the SSA region.

METHODS

Five databases were searched for publications up to December 2016. Narrative synthesis was conducted for knowledge level of CVDs, knowledge of risk factors and clinical signs, factors influencing knowledge of CVDs and source of health information on CVDs. The review was registered with Prospero (CRD42016049165).

RESULTS

Of 2212 titles and abstracts screened, 45 full-text papers were retrieved and reviewed and 20 were included: eighteen quantitative and two qualitative studies. Levels of knowledge and awareness for CVD and risk factors were generally low, coupled with poor perception. Most studies reported less than half of their study participants having good knowledge of CVDs and/or risk factors. Proportion of participants who were unable to identify a single risk factor and clinical symptom for CVDs ranged from 1.8% in a study among hospital staff in Nigeria to a high of 73% in a population-based survey in Uganda and 7% among University staff in Nigeria to 75.1% in a general population in Uganda respectively. High educational attainment and place of residence had a significant influence on the levels of knowledge for CVDs among SSA populations.

CONCLUSION

Low knowledge of CVDs, risk factors and clinical symptoms is strongly associated with the low levels of educational attainment and rural residency in the region. These findings provide useful information for implementers of interventions targeted at the prevention and control of CVDs, and encourages them to incorporate health promotion and awareness campaigns in order to enhance knowledge and awareness of CVDs in the region.

Blood Pressure Control among Hypertensive Stroke Survivors in Nigeria

BACKGROUND

Hypertension is the dominant risk factor for first-ever and recurrent stroke. The objective of the present study was to assess control of blood pressure (BP) among hypertensive stroke survivors seen at 2 tertiary hospitals in Nigeria.

METHODS

Using a cross-sectional design, stroke survivors with hypertension as a risk factor were consecutively recruited in the outpatient clinics of the participating hospitals. After the necessary demographic and clinical information had been obtained, participants had their BP assessed in a standardized manner. A BP of <140/< 90 mmHg was defined as good control. Univariate binary logistic regression analysis was performed to determine the predictors of good BP control.

RESULTS

There were 284 subjects with a mean age of 59.0 ± 13.1 years. The overall mean systolic blood pressure was 142.7 ± 22.5 mmHg (male 144.9 ± 22.7, female 138.4 ± 21.6; P > .05) while the overall mean diastolic blood pressure was 85.6 ± 14.5 mmHg (male 85.8 ± 14.6, female 85.2 ± 14.4; P > .05). In spite of the fact that 270 (95.1%) of the subjects were on antihypertensives, only 39.8% (male 37.0%, female 44.1%; P > .05) had good BP control. In univariate analysis, having at least 12 years of formal education (OR 1.672, 95% CI 1.035-2.699; P < .05) and good compliance to antihypertensive medications (OR 9.732, 95% CI 3.391-27.930; P < .001) were the only variables associated with good BP control.

CONCLUSIONS

Control of BP is poor among Nigerian hypertensive stroke survivors and is associated with the level of formal education and drug compliance. Urgent measures are needed to improve on this poor BP control as these may potentially reduce stroke recurrence rate.