Awareness Of Stroke Warning Signs And Risk Factors Among Patients With Hypertension And Diabetes Mellitus At A Tertiary-Care Hospital In Lahore, Pakistan: A Cross-Sectional Study

Background: Stroke is a major cause of mortality and long-term disability, particularly in low- and middle-income countries where delayed recognition of warning signs and inadequate control of modifiable risk factors contribute to poor outcomes. Patients with hypertension and diabetes mellitus are at increased cerebrovascular risk and represent an important target group for preventive education. Objective: To assess awareness of stroke warning signs and risk factors among patients with hypertension, diabetes mellitus, or both attending tertiary-care outpatient services at Mayo Hospital, Lahore, Pakistan. Methods: This hospital-based descriptive cross-sectional study included 281 participants recruited from the Medicine Outpatient Department, Neurology Outpatient Department, and Diabetic Clinic. Stroke awareness was assessed using a structured questionnaire covering recognition of warning signs, risk factors, and overall knowledge categories. Data were summarized as frequencies and percentages. Results: Most participants recognized that stroke affects the brain (267/281, 94.9%), and 225 participants (80.1%) were aware of FAST symptoms. Sudden weakness was recognized by 208 participants (74.0%), whereas awareness of vision problems and altered consciousness was low, reported by 81 (29.0%) and 21 (7.6%) participants, respectively. Smoking, hypertension, and diabetes mellitus were identified as risk factors by 204 (72.6%), 197 (70.0%), and 195 (69.3%) participants, respectively. Adequate overall risk-factor knowledge was present in 129 participants (45.8%). Conclusion: Stroke awareness among high-risk outpatients was partial and uneven, with substantial gaps in recognition of non-motor warning signs and comprehensive risk knowledge. Structured stroke-education strategies should be integrated into outpatient hypertension and diabetes care.