Risk Factors Associated with Stroke in Patients at the Hospitalization Service
Abstract
Stroke is a serious condition with a high risk of death and long-term disability. Hypertension is a major risk factor contributing significantly to both ischemic and hemorrhagic stroke. This study aims to identify risk factors associated with these two types of stroke. A cross-sectional design was used involving 173 hospitalized stroke patients from February 15 to July 29, 2022. Data were collected from medical records using a checklist and analyzed using univariate and bivariate methods with the Chi-square test. Independent variables included age, gender, hypertension, diabetes mellitus, and stroke type; the dependent variable was the incidence of stroke. Most patients were over 55 years old (62.8%), male (56.1%), and had hypertension (82.7%). Ischemic stroke occurred more frequently (68.2%) than hemorrhagic stroke (31.8%). Hypertension was significantly associated with stroke type (p = 0.017), whereas age (p = 0.113), gender (p = 0.545), and diabetes mellitus (p = 0.778) showed no significant association. Hypertension was the most prominent risk factor for stroke, particularly among individuals over 55. Preventive measures are essential to control hypertension. Nurses play a vital role in educating patients about the importance of maintaining healthy blood pressure and can develop stroke prevention programs based on significant risk factors. These programs may help reduce the prevalence of stroke and its impact on mortality and long-term disability.
References
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Beresniak, A., Bremond-Gignac, D., Dupont, D., & Duru, G. (2025). Reevaluating health metrics: Unraveling the limitations of disability-adjusted life years as an indicator in disease burden assessment. World Journal of Methodology, 15(1), 95796. https://doi.org/10.5662/wjm.v15.i1.95796
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Nutakki, A., Chomba, M., Chishimba, L., Zimba, S., Gottesman, R. F., Bahouth, M. N., & Saylor, D. (2021). Risk factors and outcomes of hospitalized stroke patients in Lusaka, Zambia. Journal of the Neurological Sciences, 424. https://doi.org/https://doi.org/10.1016/j.jns.2021.117404
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Pu, L., Wang, L., Zhang, R., Zhao, T., Jiang, Y., & Han, L. (2023). Projected global trends in ischemic stroke incidence, deaths and disability-adjusted life years from 2020 to 2030. Stroke, 54(5), 1330–1339. https://doi.org/https://doi.org/10.1161/STROKEAHA.122.040073
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Rangel, E. B., Rodrigues, C. O., & Sá, J. R. De. (2019). Micro- and Macrovascular Complications in Diabetes Mellitus: Preclinical and Clinical Studies. Journal of Diabetes Research. https://doi.org/https://doi.org/10.1155/2019/2161085
Ruan, R., Qi, J., Qian, Z., Zhou, M., Yang, Y., Zhang, S., Vaughn, M. G., LeBaige, M. H., Yin, P., & Lin, H. (2021). Disease burden and attributable risk factors of respiratory infections in China from 1990 to 2019. The Lancet Regional Health - Western Pacific, 11. https://doi.org/https://doi.org/10.1016/j.lanwpc.2021.100153
Thomas, Q., Crespy, V., Duloquin, G., Ndiaye, M., Sauvant, M., Béjot, Y., & Giroud, M. (2021). Stroke in women: When gender matters. Revue Neurologique, 177(8), 881–889. https://doi.org/https://doi.org/10.1016/j.neurol.2021.01.012
Turana, Y., Tengkawan, J., Chia, Y. C., Nathaniel, M., Wang, J. G., Sukonthasarn, A., Chen, C. H., Minh, H. Van, Buranakitjaroen, P., Shin, J., Siddique, S., Nailes, J. M., Park, S., Teo, B. W., Sison, J., Soenarta, A. A., Hoshide, S., Tay, J. C., & Sogunuru, G. P. (2021). Hypertension and stroke in Asia: A comprehensive review from HOPE Asia. Journal of Clinical Hypertension, 23(3), 513–521. https://doi.org/https://doi.org/10.1111/jch.14099
Wajngarten, M., & Silva, G. S. (2019). Hypertension and stroke: Update on treatment. European Cardiology Review, 14(2), 111–115. https://doi.org/https://doi.org/10.15420/ecr.2019.11.1
World Health Organization. (2023). Stroke, Cerebrovascular Accident.
Xia, X., Yue, W., Chao, B., Li, M., Cao, L., Wang, L., Shen, Y., & Li, X. (2019). Prevalence and risk factors of stroke in the elderly in Northern China: data from the National Stroke Screening Survey. Journal of Neurology, 266(6), 1449–1458. https://doi.org/https://doi.org/10.1007/s00415-019-09281-5
Xu, J., Zhang, X., Jin, A., Pan, Y., Li, Z., Meng, X., & Wang, Y. (2022). Trends and Risk Factors Associated with Stroke Recurrence in China, 2007-2018. JAMA Network Open, 5(6). https://doi.org/https://doi.org/10.1001/jamanetworkopen.2022.16341
Yi, X., Luo, H., Zhou, J., Yu, M., Chen, X., Tan, L., Wei, W., & Li, J. (2020). Prevalence of stroke and stroke related risk factors: A population based cross sectional survey in southwestern China. BMC Neurology, 20(1). https://doi.org/https://doi.org/10.1186/s12883-019-1592-z
Aycock, D. M., Clark, P. C., & Araya, S. (2019). Measurement and Outcomes of the Perceived Risk of Stroke: A Review. Western Journal of Nursing Research, 41(1), 134–154. https://doi.org/https://doi.org/10.1177/0193945917747856
Barthels, D., & Das, H. (2020). Current advances in ischemic stroke research and therapies. Biochimica et Biophysica Acta - Molecular Basis of Disease, 1886(4). https://doi.org/https://doi.org/10.1016/j.bbadis.2018.09.012
Beresniak, A., Bremond-Gignac, D., Dupont, D., & Duru, G. (2025). Reevaluating health metrics: Unraveling the limitations of disability-adjusted life years as an indicator in disease burden assessment. World Journal of Methodology, 15(1), 95796. https://doi.org/10.5662/wjm.v15.i1.95796
CDC. (2022). Stroke Facts.
Fekadu, G., Chelkeba, L., & Kebede, A. (2019). Risk factors, clinical presentations and predictors of stroke among adult patients admitted to stroke unit of Jimma university medical center, south west Ethiopia: prospective observational study. BMC Neurology, 19(1). https://doi.org/https://doi.org/10.1186/s12883-019-1409-0
Ganguly, S. S., Gujjar, A. R., Harthi, H., Al, Hashmi, A., Al, Jaju, S., Al-Mahrezi, A., & Al-Asmi, A. R. (2021). Risk factors for ischaemic stroke in an omani community a case-control study. Sultan Qaboos University Medical Journal, 21(4), 585–590. https://doi.org/https://doi.org/10.18295/squmj.4.2021.043
Gebreegziabher, B. G., Birhanu, T. E., Olana, D. D., & Tesfaye, B. T. (2021). Characteristics and Risk Factors Associated with Stroke Subtypes among Adult Patients Admitted to the Stroke Unit of Jimma University Medical Center: A Retrospective Cross-sectional Study. Current Hypertension Reviews, 17(1), 67–74. https://doi.org/https://doi.org/10.2174/1573402115666191121120228
Kim, H., & Lee, H. (2023). Risk of Stroke and Cardiovascular Disease According to Diabetes Mellitus Status. Western Journal of Nursing Research, 45(6), 520–527. https://doi.org/https://doi.org/10.1177/01939459231158212
Kim, T. H., Yang, P. S., Yu, H. T., Jang, E., Shin, H., Kim, H. Y., Uhm, J. S., Kim, J. Y., Sung, J. H., Pak, H. N., Lee, M. H., Joung, B., & Lip, G. Y. H. (2019). Effect of hypertension duration and blood pressure level on ischaemic stroke risk in atrial fibrillation: Nationwide data covering the entire Korean population. European Heart Journal, 40(10), 809–819. https://doi.org/https://doi.org/10.1093/eurheartj/ehy877
Kitagawa, K. (2022). Blood pressure management for secondary stroke prevention. Hypertension Research : Official Journal of the Japanese Society of Hypertension, 45(6), 936–943. https://doi.org/https://doi.org/https://doi.org/10.1038/s41440-022-00908-1
Lau, L. H., Lew, J., Borschmann, K., Thijs, V., & Ekinci, E. I. (2019). Prevalence of diabetes and its effects on stroke outcomes: A meta-analysis and literature review. Journal of Diabetes Investigation, 10(3), 780–792. https://doi.org/https://doi.org/10.1111/jdi.12932
Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan. (2019). Laporan Provinsi Kepuluan Riau RIKESDAS 2018.
Maida, C. D., Daidone, M., Pacinella, G., Norrito, R. L., Pinto, A., & Tuttolomondo, A. (2022). Diabetes and Ischemic Stroke: An Old and New Relationship an Overview of the Close Interaction between These Diseases. International Journal of Molecular Sciences, 23(4). https://doi.org/https://doi.org/10.3390/ijms23042397
Maksimova, M. Y., & Airapetova, A. S. (2019). Gender differences in stroke risk factors. Zh Nevrol Psikhiatr Im S S Korsakova, 119(12), 58–64. https://doi.org/https://doi.org/10.17116/jnevro201911912258
Nutakki, A., Chomba, M., Chishimba, L., Zimba, S., Gottesman, R. F., Bahouth, M. N., & Saylor, D. (2021). Risk factors and outcomes of hospitalized stroke patients in Lusaka, Zambia. Journal of the Neurological Sciences, 424. https://doi.org/https://doi.org/10.1016/j.jns.2021.117404
Pandian, J. D., Gall, S. L., Kate, M. P., Silva, G. S., Akinyemi, R. O., & Ovbiagele, B. I. (2018). Prevention of stroke: a global perspective. The Lancet, 392(10154), 1269–1278. https://doi.org/10.1016/S0140-6736(18)31269-8.
Pu, L., Wang, L., Zhang, R., Zhao, T., Jiang, Y., & Han, L. (2023). Projected global trends in ischemic stroke incidence, deaths and disability-adjusted life years from 2020 to 2030. Stroke, 54(5), 1330–1339. https://doi.org/https://doi.org/10.1161/STROKEAHA.122.040073
Ram, C. V. S., Kumar, S., Renjen, P. N., Kumar, G. P., Swaminathan, J., Reddy, C. R., Kondati, S., Sharma, M., Selvan, V. L. A., Sundaram, M., Vasudevan, A., & Lackland, D. (2021). Risk factors predisposing to acute stroke in India: a prospective study. Journal of Hypertension, 39(11). https://doi.org/10.1097/HJH.0000000000002915
Rangel, E. B., Rodrigues, C. O., & Sá, J. R. De. (2019). Micro- and Macrovascular Complications in Diabetes Mellitus: Preclinical and Clinical Studies. Journal of Diabetes Research. https://doi.org/https://doi.org/10.1155/2019/2161085
Ruan, R., Qi, J., Qian, Z., Zhou, M., Yang, Y., Zhang, S., Vaughn, M. G., LeBaige, M. H., Yin, P., & Lin, H. (2021). Disease burden and attributable risk factors of respiratory infections in China from 1990 to 2019. The Lancet Regional Health - Western Pacific, 11. https://doi.org/https://doi.org/10.1016/j.lanwpc.2021.100153
Thomas, Q., Crespy, V., Duloquin, G., Ndiaye, M., Sauvant, M., Béjot, Y., & Giroud, M. (2021). Stroke in women: When gender matters. Revue Neurologique, 177(8), 881–889. https://doi.org/https://doi.org/10.1016/j.neurol.2021.01.012
Turana, Y., Tengkawan, J., Chia, Y. C., Nathaniel, M., Wang, J. G., Sukonthasarn, A., Chen, C. H., Minh, H. Van, Buranakitjaroen, P., Shin, J., Siddique, S., Nailes, J. M., Park, S., Teo, B. W., Sison, J., Soenarta, A. A., Hoshide, S., Tay, J. C., & Sogunuru, G. P. (2021). Hypertension and stroke in Asia: A comprehensive review from HOPE Asia. Journal of Clinical Hypertension, 23(3), 513–521. https://doi.org/https://doi.org/10.1111/jch.14099
Wajngarten, M., & Silva, G. S. (2019). Hypertension and stroke: Update on treatment. European Cardiology Review, 14(2), 111–115. https://doi.org/https://doi.org/10.15420/ecr.2019.11.1
World Health Organization. (2023). Stroke, Cerebrovascular Accident.
Xia, X., Yue, W., Chao, B., Li, M., Cao, L., Wang, L., Shen, Y., & Li, X. (2019). Prevalence and risk factors of stroke in the elderly in Northern China: data from the National Stroke Screening Survey. Journal of Neurology, 266(6), 1449–1458. https://doi.org/https://doi.org/10.1007/s00415-019-09281-5
Xu, J., Zhang, X., Jin, A., Pan, Y., Li, Z., Meng, X., & Wang, Y. (2022). Trends and Risk Factors Associated with Stroke Recurrence in China, 2007-2018. JAMA Network Open, 5(6). https://doi.org/https://doi.org/10.1001/jamanetworkopen.2022.16341
Yi, X., Luo, H., Zhou, J., Yu, M., Chen, X., Tan, L., Wei, W., & Li, J. (2020). Prevalence of stroke and stroke related risk factors: A population based cross sectional survey in southwestern China. BMC Neurology, 20(1). https://doi.org/https://doi.org/10.1186/s12883-019-1592-z
Published
2025-05-27
How to Cite
ELMUKHSINUR, Elmukhsinur; ROSY, Alice; KURNIADI, Rizki.
Risk Factors Associated with Stroke in Patients at the Hospitalization Service.
Adi Husada Nursing Journal, [S.l.], v. 11, n. 1, p. 1-9, may 2025.
ISSN 2502-2083.
Available at: <https://www.adihusada.ac.id/jurnal/index.php/AHNJ/article/view/ahnj.v11i1.518>. Date accessed: 18 sep. 2025.
doi: https://doi.org/10.37036/ahnj.v11i1.518.
Section
Articles
Keywords
Hemorrhagic, Ischemic, Risk Factors, Stroke
This work is licensed under a Creative Commons Attribution 4.0 International License.
