Heart failure was associated with a higher prevalence of stroke or TIA (26.3% vs 8.5%, P<0.0001), an effect that remained significant after adjustment only in the lowest SBP tertile (OR 3.0).
Cross-Sectional (n=21,453)
Yes
Is heart failure associated with an increased prevalence of stroke or TIA, and how does systolic blood pressure affect this relationship?
Heart failure is associated with a significantly increased prevalence of stroke or TIA, with the highest risk observed in patients with low systolic blood pressure (<119.5 mm Hg).
Absolute Event Rate: 26.3% vs 8.5%
p-value: p=<0.0001
BACKGROUND AND PURPOSE: The prevalence of stroke is increased in individuals with heart failure (HF). The stroke mechanism in HF may be cardiogenic embolism or cerebral hypoperfusion. Stroke risk increases with decreasing ejection fraction and low cardiac output is associated with hypotension and poor survival. We examine the relationship among blood pressure level, history of stroke/transient ischemic attack (TIA), and HF. METHODS: We compared the prevalence of self-reported history of stroke or TIA in the REasons for Geographic And Racial Differences in Stroke (REGARDS) participants with HF (as defined by current digoxin use) and without HF. We excluded participants with atrial fibrillation or missing data. We examined the relationship between HF and history of stroke/TIA within tertiles of systolic blood pressure (SBP) adjusting for patient demographic and health characteristics. RESULTS: Prevalent stroke/TIA were reported by 66 (26.3%) of 251 participants with and 1805 (8.5%) of 21 202 participants without HF (Por=119.5 but or=131.5 mm Hg. After adjustment, the relationship between prior stroke/TIA and HF remained significant only within the lowest tertile of SBP (<119.5 mm Hg; 3.0; 1.5 to 6.1). CONCLUSIONS: The odds of prevalent self-reported stroke/TIA are increased in participants with HF and most markedly increased in participants with low SBP. Longitudinal data are needed to determine whether this reflects stroke/TIA secondary to thromboembolism from poor cardiac function or secondary to cerebral hypoperfusion.
Pullicino et al. (Sex,) realizaram um estudo transversal em insuficiência cardíaca e acidente vascular cerebral (n=21.453). Insuficiência cardíaca vs. Sem insuficiência cardíaca foi avaliada com base na história de acidente vascular cerebral ou TIA auto-relatada prevalente (p=<0,0001). A insuficiência cardíaca foi associada a uma maior prevalência de acidente vascular cerebral ou TIA (26,3% vs 8,5%, P<0,0001), um efeito que permaneceu significativo após ajuste apenas no menor tertile de PAS (OR 3,0).