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Prevalence of stroke in systolic heart failure
Kathy Hebert1, Mohamed Kaif, Leonard Tamariz
1Division of Cardiology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA. khebert1@gmail.com
Insights
Stroke prevalence varied among heart failure patients across three regions. Lower beta-blocker use in Georgia correlated with lower reported stroke rates, suggesting a potential link needing further study.
Area of Science:
- Cardiology
- Neurology
- Public Health
Background:
- Heart disease is a significant risk factor for stroke.
- Heart failure (HF) patients are a vulnerable subgroup with poor outcomes and high stroke recurrence.
- Understanding stroke prevalence in HF populations is crucial for risk stratification.
Purpose of the Study:
- To examine the prevalence of self-reported stroke in patients with systolic heart failure across three distinct geographic regions.
- To identify potential factors influencing stroke prevalence in this population.
Main Methods:
- A comparative analysis of stroke prevalence was conducted in participants with systolic HF from Louisiana, Florida, and Georgia.
- Data included patient demographics, health characteristics, and medication use, specifically beta-blockers.
- Multivariable adjustments were applied to account for confounding factors.
Main Results:
- Stroke prevalence varied significantly, with lower rates reported in Georgia compared to Florida and Louisiana.
- Patients on beta-blocker medication were over 3.5 times more likely to report a history of stroke.
- Beta-blocker use was substantially lower in Georgia (7%) compared to Florida (87%) and Louisiana (94%).
Conclusions:
- Reported stroke prevalence in heart failure patients is inconsistent across different geographic locations.
- Lower beta-blocker use in the Georgia cohort may partially explain the observed lower stroke prevalence.
- Further longitudinal research is necessary to investigate the potential association between beta-blockers and stroke risk in heart failure patients.
Background:
Heart disease is a major independent risk factor for stroke, ranking third after age and hypertension. Heart failure (HF) patient constitutes an important subgroup of patients with stroke, because of their poor outcome and high rates of mortality and stroke recurrence. We examined the prevalence of stroke in patients with heart failure from 3 different geographic regions.
Methods And Results:
We compared the prevalence of self-reported history of stroke in participants with systolic HF from 3 different geographic regions (Houma, LA; Miami, FL; and Tbilisi, Georgia, Eastern Europe). We examined the prevalence of stroke/adjusting for patient demographic and health characteristics. Stroke prevalence was reported by 79 (7.8%) of 1017 participants from Louisiana, 51 (9.2%) of 556 participants from Florida, and 5 (1.3%) of 383 participants from Georgia. After multivariable adjustment, the prevalence of stroke was significantly lower in Georgia compared to Florida and Louisiana sites. Patients on β-blocker medication were 3.58 times (95% CI 1.96-6.55) more likely to report stroke compared to those without β-blockers (×2 = 19.5, P ≤ .0001). There were significantly fewer participants on β-blockers from Georgia (7%) compared to participants from Florida (87%) and Louisiana (94%; (×2 = 24.3, P<.001).
Conclusions:
Self-reported stroke prevalence in participants with HF was not consistent among the 3 sites. These differences in prevalence may in part be explained by the lower reported use of β-blockers in the Georgia site. Longitudinal studies are needed to determine whether β-blockers increase the risk of stroke in HF population.
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