Prevalence of newly diagnosed hypertension in patients presenting with stroke at the medical emergency Department of Rwanda Military Referral and Teaching Hospital: a five-years retrospective study (2020–2025)

Hypertension is a leading modifiable risk factor for stroke, especially in low- and middle-income countries. In Rwanda, stroke remains a significant public health concern; however, local data on the epidemiological profile of hypertension among stroke patients are limited. This study aimed to assess the prevalence and characteristics of newly diagnosed hypertension in patients presenting with stroke at the Medical Emergency Department of the Rwanda Military Referral and Teaching Hospital. This retrospective study reviewed the records of 227 stroke patients admitted from June 2020 to May 2025 at RMRTH. Data on demographics, hypertension status, adherence, stroke type, and admission blood pressure were collected. The Analyses used SPSS version 27 with descriptive statistics, 95% CIs, and subgroup comparisons by hypertension status, age, and sex. The median age of the patients was 65 years, and 66.1% were male. Ischemic stroke was the predominant subtype, accounting for 58.1% of cases. Hypertension was highly prevalent: 59.0% had a prior diagnosis, 23.3% were newly diagnosed upon admission, and only 17.6% had no hypertension. Among patients with known hypertension, 93.2% reported poor adherence to antihypertensive medication. The mean admission blood pressure was highest in patients with newly diagnosed hypertension (166/100 mmHg), followed closely by those with known hypertension (163/99 mmHg), while normotensive patients had lower mean values (128/82 mmHg). Poor medication adherence was associated with a significantly higher mean blood pressure (165/100 mmHg) compared with good adherence (144/90 mmHg). Additionally, males had a slightly higher mean blood pressure than females (161/96 mmHg vs. 151/97 mmHg, respectively). This study reveals a substantial burden of both diagnosed and undiagnosed hypertension among patients presenting with stroke in Rwanda. The high prevalence of poor adherence to antihypertensive therapy and elevated blood pressures at presentation suggest a critical need for enhanced community-based hypertension screening and timely linkage to care. Tailored interventions targeting early detection and improved medication adherence could significantly reduce stroke incidence and improve outcome.