Relationship of Stroke to Other Cardiovascular Disease

The frequencies of prior cardiovascular abnormalities were compared in 117 stroke patients and 234 control subjects. All were residents of a retirement community who had been examined initially and followed in the local medical clinic before the strokes occurred. Cases and controls were matched for age, sex, length of residence, and blood pressure. Prior coronary, rheumatic, and hypertensive heart disease were all more frequent in cases than in controls, as were cardiac enlargement, congestive heart failure, and digitalis therapy. There was a stronger association of stroke with atrial fibrillation than with other cardiac abnormalities, suggesting that atrial fibrillation in the elderly is an important precursor of stroke and should not be regarded lightly. Aortic calcification and intermittent claudication were also more frequent among the stroke cases than the controls. Since the blood pressures of cases and controls were matched, the association of both cardiac disease and noncerebral atherosclerosis with stroke is independent of blood pressure and is not attributable to the fact that hypertension predisposes to all of these conditions.