Alarming rate of hemorrhagic stroke showing an urgent need for hypertension control: a retrospective study from a major stroke center in Sindh

Background and Objective: Hemorrhagic stroke accounts for approximately 18–20% of the global stroke burden and is associated with high mortality and disability. It poses a significant challenge in low- and middle-income countries, where delayed presentation and inadequate risk factor control worsen outcomes. Hypertension remains the most important modifiable risk factor, particularly when poorly controlled. The objective of this study was to investigate the incidence of hemorrhagic stroke at a major stroke center and its association with uncontrolled hypertension. Methods: This retrospective study was conducted at Sindh institute of cardiovascular diseases (SICVD) Sukkur over three months, from May to July 2024. A total of 271 stroke patients were included. Data were analyzed to determine the distribution of stroke subtypes and the prevalence of hypertension. Statistical methods such as the chi-square test and logistic regression were used to evaluate the correlation between hypertension control and the incidence of hemorrhagic stroke. Results: Hemorrhagic stroke accounted for 25.7% of all stroke cases. Among patients with hemorrhagic stroke, 87.1% had uncontrolled hypertension. A statistically significant association was observed between uncontrolled hypertension and hemorrhagic stroke (p < 0.05). Conclusion:  The incidence of hemorrhagic stroke at SICVD Sukkur was higher than global estimates and was strongly associated with poor hypertension control. These findings highlight the need for improved hypertension management strategies to reduce the burden of hemorrhagic stroke.