Abstract Background and aims Hypertension is the leading modifiable risk factor for stroke, yet it frequently remains undiagnosed or poorly controlled in low- and middle-income countries and data in country like Rwanda are very limited. We assessed the prevalence and clinical characteristics of newly diagnosed hypertension among patients presenting with stroke at the emergency department of Rwanda Military Referral and Teaching Hospital (RMRTH). Methods We conducted a retrospective review of adult stroke admissions at RMRTH from June 2020 to May 2025 (n=227). Stroke was confirmed by non-contrast CT. Hypertension status was categorized as known, newly diagnosed (≥140/90 mmHg on repeated measurements during admission), or none. Demographics, stroke subtype, admission blood pressure, and documented antihypertensive adherence were extracted; analyses were descriptive. Results Median age was 65 years and 66.1% were male. Ischemic stroke comprised 58.1% and hemorrhagic stroke 37.0%. Overall, 82.3% had hypertension: 59.0% previously known and 23.3% newly diagnosed at presentation; 17.6% had no hypertension. Mean admission blood pressure was highest among newly diagnosed patients (166/100 mmHg) and similarly elevated in known hypertension (163/99 mmHg) versus normotensive patients (128/82 mmHg). Among patients with known hypertension, 93.2% had documented poor medication adherence. As a conclusion, nearly one in four stroke patients had previously undiagnosed hypertension, and most patients with known hypertension had poor adherence and markedly elevated admission blood pressure. Strengthening community hypertension screening, linkage to care, and adherence-focused interventions could reduce stroke burden in Rwanda. Conflict of interest Olivier Uwishema. nothing to disclose
Olivier Uwishema (Fri,) studied this question.