ARTERIAL HYPERTENSION AND DIABETES MELLITUS – IMPORTANT RISK FACTORS OF STROKE

Objective: Stroke is a very common cause of morbidity and mortality, and in patients who suffered stroke, subsequent long-term neurological deficit can persist. Numerous clinical and epidemiological studies have confirmed that increased systemic blood pressure values are among the main risk factors for ischaemic and haemorrhagic stroke. Arterial hypertension is now the leading cause of mortality worldwide. Due to the ageing of the population, the increasing incidence of obesity and the socio-economic changes, the incidence of arterial hypertension and diabetes mallitus is increasing rapidly worldwide. Hypertension is common in patients with type 2 diabetes mellitus, obese patients, patients with dyslipidaemia, patients with sedentary lifestyles, and also in active smokers – which again increases the risk of developing hypertension. Design and method: We retrospectively reviewed a group of patients hospitalized during six months period at our Department of Neurology with the diagnosis of stroke confirmed by imaging (CT, CT angiography, brain MRI). We analysed 218 patients, including 145 men (66.5%) and 73 women (33.5%). The average age was 70.8 years. 120 patients (55.0%) were treated for diabetes mellitus. 182 patients (83.5%) have been diagnosed with ischemic stroke and 36 patients (16.5%) with hemorrhagic stroke. Results: Arterial hypertension was very common in our group of patients. We detected arterial hypertension in 199 subjects (91.2%). In the haemorrhagic stroke group was arterial hypertension in 31 subjects (86,1%). Most of them had stage 3 arterial hypertension according to the ESH classification. Conclusions: Arterial hypertension was highly prevalent in our cohort of stroke patients. Arterial hypertension and as well as diabetes mellitus alone represent diseases with increased risk of cardiovascular diseases. The presence of both conditions increases the risk 2-4 times and therefore it is often proclaimed as lethal duo. To manage hypertension in patients with the diagnose diabetes mellitus it is necessary to focus on the interference of antihypertensive agents with metabolic control, insulin resistance, lipid metabolism, mineral and fluid balance.