Predicting stroke risk in hypertensive patients with coronary artery disease: a report from the INVEST

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Antonio Coca1, Franz H Messerli, Athanase Benetos

  • 1Hospital Clinic (IDIBAPS), University of Barcelona, Barcelona, Spain.

Stroke
|December 29, 2007
PubMed

Insights

Stroke risk in hypertensive coronary artery disease patients is influenced by various factors. Achieving blood pressure below 140/90 mm Hg significantly reduces stroke risk, while factors like black race and prior heart attack increase it.

Area of Science:

  • Cardiology
  • Neurology
  • Hypertension Management

Background:

  • Understanding stroke risk factors in coronary artery disease (CAD) patients is crucial.
  • Hypertension is a common comorbidity in CAD patients, increasing stroke risk.

Purpose of the Study:

  • To identify predictors of stroke in hypertensive, stable CAD patients.
  • To analyze the impact of baseline characteristics and blood pressure control on stroke risk.

Main Methods:

  • Analysis of 22,576 patients from the INternational VErapamil SR-trandolapril STudy (INVEST).
  • Utilized Cox proportional-hazards models to identify stroke predictors.
  • Examined baseline characteristics and on-treatment blood pressure (BP).

Main Results:

  • Stroke occurred in 377 patients (6.1/1000 patient-years), with 28% fatal.
  • Increased stroke risk associated with older age, black race, US residency, prior myocardial infarction, smoking, stroke/TIA, arrhythmia, diabetes, and bypass surgery.
  • Achieving BP <140/90 mm Hg significantly reduced stroke risk.

Conclusions:

  • Stroke is a significant, often fatal, complication in hypertensive CAD patients.
  • Black race, US residency, severe vascular disease, and arrhythmia predict higher stroke risk.
  • Effective blood pressure control (<140/90 mm Hg) is key to reducing stroke risk.
Abstract

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