Lisandro D Colantonio1, Christopher M Gamboa2, Dawn O Kleindorfer3, April P Carson1, Virginia J Howard1, Paul Muntner1, Mary Cushman4, George Howard5, Monika M Safford6. 1. Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States. 2. Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States. 3. Department of Neurology, School of Medicine, University of Cincinnati, Cincinnati, OH, United States. 4. Department of Medicine, School of Medicine, University of Vermont, Burlington, VT, United States. 5. Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States. 6. Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States; General Internal Medicine, Weill Cornell Medicine, New York, NY, United States. Electronic address: mms9024@med.cornell.edu.
Abstract
BACKGROUND: Many adults without cerebrovascular disease report a history of stroke symptoms, which is associated with higher risk for stroke. Because stroke and coronary heart disease (CHD) share many risk factors, we examined the association between a history of stroke symptoms and incident CHD. METHODS: We analyzed data from 8999 black and 12,499 white REasons for Geographic And Racial Differences in Stroke (REGARDS) study participants without a prior myocardial infarction, stroke or transitory ischemic attack enrolled in 2003-2007 (total participants=21,498, all ≥45years of age). A history of stroke symptoms (i.e., unilateral weakness, unilateral numbness, full-field vision loss, half-field vision loss, understanding problems and communication problems) was assessed at baseline using the Questionnaire for Verifying Stroke-Free Status. Participants were followed for incident CHD and CHD death through December 2011. RESULTS: Overall, 3432 (16.0%) participants reported a history of stroke symptoms (1771 [19.7%] blacks and 1661 [13.3%] whites). There were 701 incident CHD events including 209 CHD deaths over a median follow-up of 5.8years. After adjustment for CHD risk factors, hazard ratios (95% confidence interval [95% CI]) for incident CHD associated with reporting any versus no stroke symptoms were 1.26 (1.04-1.51) in the overall population, 1.28 (0.99-1.65) among blacks and 1.23 (0.94-1.61) among whites. Multivariable-adjusted hazard ratios (95% CI) for CHD death associated with any versus no stroke symptoms were 1.50 (1.10-2.06) overall, 1.58 (1.07-2.32) among blacks and 1.41 (0.82-2.43) among whites. CONCLUSION: A history of stroke symptoms is associated with a higher incidence of CHD among black and white adults.
BACKGROUND: Many adults without cerebrovascular disease report a history of stroke symptoms, which is associated with higher risk for stroke. Because stroke and coronary heart disease (CHD) share many risk factors, we examined the association between a history of stroke symptoms and incident CHD. METHODS: We analyzed data from 8999 black and 12,499 white REasons for Geographic And Racial Differences in Stroke (REGARDS) study participants without a prior myocardial infarction, stroke or transitory ischemic attack enrolled in 2003-2007 (total participants=21,498, all ≥45years of age). A history of stroke symptoms (i.e., unilateral weakness, unilateral numbness, full-field vision loss, half-field vision loss, understanding problems and communication problems) was assessed at baseline using the Questionnaire for Verifying Stroke-Free Status. Participants were followed for incident CHD and CHD death through December 2011. RESULTS: Overall, 3432 (16.0%) participants reported a history of stroke symptoms (1771 [19.7%] blacks and 1661 [13.3%] whites). There were 701 incident CHD events including 209 CHD deaths over a median follow-up of 5.8years. After adjustment for CHD risk factors, hazard ratios (95% confidence interval [95% CI]) for incident CHD associated with reporting any versus no stroke symptoms were 1.26 (1.04-1.51) in the overall population, 1.28 (0.99-1.65) among blacks and 1.23 (0.94-1.61) among whites. Multivariable-adjusted hazard ratios (95% CI) for CHD death associated with any versus no stroke symptoms were 1.50 (1.10-2.06) overall, 1.58 (1.07-2.32) among blacks and 1.41 (0.82-2.43) among whites. CONCLUSION: A history of stroke symptoms is associated with a higher incidence of CHD among black and white adults.
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