Hypertension Characteristics and Neuroimaging Markers of Cerebrovascular Injury in Young Hypertensive Adults With Acute Cerebrovascular Events.

Stroke among young adults is a growing public health problem in sub-Saharan Africa, where hypertension is the leading modifiable risk factor for cerebrovascular injury (CVI). We aimed to describe hypertension patterns and associated CVI among young adults with stroke in Senegal. We conducted a cross-sectional study among adults aged ≤ 50 years with neuroimaging-confirmed stroke in Senegal. We collected demographic characteristics, vascular risk factors, blood pressure parameters, MRI findings, and clinical outcomes. Hypertension was categorized as previously diagnosed, newly diagnosed, treated, or untreated. We performed multivariable analyses to identify predictors of stroke severity, CVI, and outcomes. A total of 94 patients were included, with a mean age of 45.0 ± 4.3 years; 55.3% were female. Mean admission systolic and diastolic blood pressures were 150.31 ± 31.8 mmHg and 90.83 ± 22.03 mmHg, respectively, and 42.5% presented with severe hypertension. Primary hypertension accounted for 97.9% of hypertension cases. White matter hyperintensities were the most frequent marker of CVI and were significantly associated with stroke severity (p = 0.016) and poorer functional outcomes at discharge (p = 0.035). In multivariable regression, CVI remained significantly associated with stroke severity (B = 3.35, 95% CI 0.18-6.49, p = 0.032). Hemorrhagic stroke was associated with higher admission systolic and diastolic blood pressure (p = 0.001 for both). Young adults in this cohort demonstrated a high burden of hypertension-related CVI.