What is the clinical evidence from this study?

Study design: Observational. Population: Stroke (n=36). Primary outcome: Prevalence of hypertension as a risk factor.

What question did this study set out to answer?

This study aimed to identify risk factors for stroke among young adults aged 18-45 in Northern Nigeria.

March 28, 2026Open Access

Hypertension as the Leading Cause of Stroke in Young Adults in a Northern Nigerian Hospital: A Retrospective Study

Key Result

Hypertension was the predominant risk factor for stroke among young adults, occurring in 52.8% of cases, with ischemic stroke being the most common subtype (69.4%).

Key Points

This study aimed to identify risk factors for stroke among young adults aged 18-45 in Northern Nigeria.
Conducted a retrospective study reviewing medical records from a hospital in Northern Nigeria.
Included young adults aged 18-45 years with brain imaging-confirmed stroke from 2023 to 2025.
Extracted demographic and clinical data including stroke subtype and associated risk factors.
Used descriptive statistics and the Mann-Whitney U test for age comparisons; Fisher’s exact test for risk factor associations.
Out of 36 young adults, 58.3% were females and the mean ages were 40.5 years for males and 35.3 years for females.
Ischemic stroke was the most common subtype, occurring in 69.4% of cases.
Hypertension was found in 52.8% of cases, being more frequent in females than males.
Other risk factors included cardiac disease, diabetes, smoking, HIV, and illicit drug use, but no significant associations with stroke subtypes were observed.

Study Design

Type

Observational (n=36)

Multicenter

Structured PICO

Population

Young adults aged 18-45 years with brain imaging-confirmed stroke

Outcome

Predominant risk factors for stroke and stroke subtypes

Hypertension is the leading modifiable risk factor for stroke among young adults in Northern Nigeria, highlighting the critical need for early blood pressure screening and management in this demographic.

Limitations

Retrospective, single-center design limits generalizability
Reliance on electronic health records may have resulted in incomplete documentation
Small sample size limited the power to detect statistically significant associations
Possibility of incomplete case capture or referral bias

Abstract

Background and aim: Stroke is traditionally considered a disease of older adults; however, its incidence among young adults aged 18-45 years is increasing globally. In sub-Saharan Africa, stroke burden remains high, yet data on its risk factors in young adults are limited. This study aimed to identify and determine the predominant risk factors for stroke among young adults in Northern Nigeria. Methods: A hospital-based retrospective study was conducted at Federal Teaching Hospital Katsina. Medical records of patients aged 18-45 years with brain imaging-confirmed stroke from January 2023 to December 2025 were reviewed. Demographic and clinical data, including stroke subtype and risk factors, were extracted. Descriptive statistics summarized the distribution of risk factors and stroke subtypes. Age differences between stroke types were analyzed using the Mann-Whitney U test, and associations between risk factors and stroke subtype were assessed using Fisher’s exact test. Results: A total of 36 young adults met the inclusion criteria. Females accounted for 21 (58.3%) cases, while males accounted for 15 (41.7%) cases. The mean age was 40.5±4.7 years for males and 35.3±7.7 years for females. Ischemic stroke was the predominant subtype, 25 (69.4%), with hemorrhagic stroke accounting for 11 (30.6%) cases. Hypertension was the most common risk factor, occurring in 19 (52.8%) cases and being more frequent in females than in males. Other risk factors included cardiac disease in three (8.3%) cases, diabetes mellitus in three (8.3%) cases, smoking in three (8.3%) cases, HIV infection in two (5.6%) cases, and illicit drug use in two (5.6%) cases. Most risk factors were restricted to one stroke subtype. No significant associations were found between individual risk factors and stroke subtypes (all p>0.05), likely due to the small sample size. Conclusion: Hypertension is the predominant and clinically significant risk factor for stroke among young adults in Northern Nigeria, with ischemic stroke being the most common subtype. The predominance of modifiable risk factors underscores the need for early detection, routine blood pressure screening, lifestyle modification, and public health interventions targeting young adults. Larger multicenter studies are warranted to further characterize stroke epidemiology and guide preventive strategies in sub-Saharan Africa.

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