Cardiovascular comorbidities and blood pressure control in stroke survivors

Manoj Kesarwani, Alejandro Perez, Victor A. Lopez, Nathan D. Wong, Stanley S. Franklin

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Objective To examine the association of cardiovascular (CV) comorbidities with the likelihood of being a stroke survivor and to determine the prevalence, treatment, and control of hypertension in this population. Methods In the National Health and Nutrition Examination Survey from 1999 to 2004, 495 stroke survivors, aged 20 years or older, were characterized by CV risk factors and comorbidities. Hypertension prevalence, treatment, and control rates were determined and logistic regression was performed to examine the likelihood of stroke according to the presence of comorbidities. Results Of the stroke survivors, 59.4% were women, 57.1 % were at least 65 years of age, 66.2% were overweight/obese, 25.1 % were current smokers, 75.1 % had hypertension, and 79.3% had additional comorbidities, including diabetes mellitus (24.7%), coronary artery disease (28.8%), chronic kidney disease (25.3%), heart failure (16.5%), and peripheral arterial disease (10.9%). The odds (and 95% confidence intervals) of prevalent stroke were 2.2 (1.5-3.2), 5.0 (3.2-7.8), 4.1 (2.1-7.8), and 10.0 (4.8-20.9) with one, two, three, and four or more comorbidities, respectively. Of these high-risk stroke survivors with comorbidities and hypertension, 18% were not receiving antihypertensive therapy; of those receiving therapy, 55.3% did not meet a systolic blood pressure goal of less than 140mmHg and, on average, were 20 mmHg above this target. Conclusion A high percentage of stroke survivors, projected to 4.98 million adults in the USA have multiple CV risk factors, numerous comorbidities, and poor control of hypertension, placing them at increased risk for further complications. Therefore, increased efforts must be made to reduce overall global risk in these high-risk persons.

Original languageEnglish (US)
Pages (from-to)1056-1063
Number of pages8
JournalJournal of Hypertension
Volume27
Issue number5
DOIs
StatePublished - May 1 2009
Externally publishedYes

Fingerprint

Survivors
Comorbidity
Stroke
Blood Pressure
Hypertension
Nutrition Surveys
Peripheral Arterial Disease
Therapeutics
Chronic Renal Insufficiency
Antihypertensive Agents
Coronary Artery Disease
Diabetes Mellitus
Heart Failure
Logistic Models
Confidence Intervals
Population

Keywords

  • Cardiovascular disease
  • Epidemiology
  • Hypertension
  • Stroke

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Cardiovascular comorbidities and blood pressure control in stroke survivors. / Kesarwani, Manoj; Perez, Alejandro; Lopez, Victor A.; Wong, Nathan D.; Franklin, Stanley S.

In: Journal of Hypertension, Vol. 27, No. 5, 01.05.2009, p. 1056-1063.

Research output: Contribution to journalArticle

Kesarwani, Manoj ; Perez, Alejandro ; Lopez, Victor A. ; Wong, Nathan D. ; Franklin, Stanley S. / Cardiovascular comorbidities and blood pressure control in stroke survivors. In: Journal of Hypertension. 2009 ; Vol. 27, No. 5. pp. 1056-1063.
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AB - Objective To examine the association of cardiovascular (CV) comorbidities with the likelihood of being a stroke survivor and to determine the prevalence, treatment, and control of hypertension in this population. Methods In the National Health and Nutrition Examination Survey from 1999 to 2004, 495 stroke survivors, aged 20 years or older, were characterized by CV risk factors and comorbidities. Hypertension prevalence, treatment, and control rates were determined and logistic regression was performed to examine the likelihood of stroke according to the presence of comorbidities. Results Of the stroke survivors, 59.4% were women, 57.1 % were at least 65 years of age, 66.2% were overweight/obese, 25.1 % were current smokers, 75.1 % had hypertension, and 79.3% had additional comorbidities, including diabetes mellitus (24.7%), coronary artery disease (28.8%), chronic kidney disease (25.3%), heart failure (16.5%), and peripheral arterial disease (10.9%). The odds (and 95% confidence intervals) of prevalent stroke were 2.2 (1.5-3.2), 5.0 (3.2-7.8), 4.1 (2.1-7.8), and 10.0 (4.8-20.9) with one, two, three, and four or more comorbidities, respectively. Of these high-risk stroke survivors with comorbidities and hypertension, 18% were not receiving antihypertensive therapy; of those receiving therapy, 55.3% did not meet a systolic blood pressure goal of less than 140mmHg and, on average, were 20 mmHg above this target. Conclusion A high percentage of stroke survivors, projected to 4.98 million adults in the USA have multiple CV risk factors, numerous comorbidities, and poor control of hypertension, placing them at increased risk for further complications. Therefore, increased efforts must be made to reduce overall global risk in these high-risk persons.

KW - Cardiovascular disease

KW - Epidemiology

KW - Hypertension

KW - Stroke

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