Division of Cardiology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
J Card Fail. 2011 Jan;17(1):76-81. doi: 10.1016/j.cardfail.2010.08.008.
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.
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).
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.
心脏病是中风的一个主要独立风险因素，排在年龄和高血压之后，位列第三。心力衰竭（HF）患者是中风患者的一个重要亚组，因为他们的预后不良，死亡率和中风复发率都很高。我们检查了来自 3 个不同地理区域的心力衰竭患者中风的患病率。
我们比较了来自 3 个不同地理区域（路易斯安那州的侯马；佛罗里达州的迈阿密；和格鲁吉亚的第比利斯）的收缩性心力衰竭患者中自我报告的中风史的患病率。我们检查了中风的患病率/调整患者的人口统计学和健康特征。路易斯安那州的 1017 名参与者中有 79 名（7.8%）报告有中风史，佛罗里达州的 556 名参与者中有 51 名（9.2%）报告有中风史，格鲁吉亚的 383 名参与者中有 5 名（1.3%）报告有中风史。经过多变量调整后，与佛罗里达州和路易斯安那州相比，格鲁吉亚的中风患病率明显较低。与没有使用β受体阻滞剂的患者相比，使用β受体阻滞剂的患者报告中风的可能性要高 3.58 倍（95%CI 1.96-6.55）（x2 = 19.5，P ≤.0001）。来自格鲁吉亚的参与者中使用β受体阻滞剂的比例明显低于佛罗里达州（7%比 87%）和路易斯安那州（94%）（x2 = 24.3，P<.001）。
HF 患者中风的自我报告患病率在 3 个地点并不一致。这些患病率的差异部分可能是由于格鲁吉亚报告的β受体阻滞剂使用率较低所致。需要进行纵向研究，以确定β受体阻滞剂是否会增加 HF 人群中风的风险。
