Blood Pressure and Stroke in Heart Failure in the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study

Pullicino, Patrick; McClure, Leslie A.; Wadley, Virginia G.; Ahmed, Ali; Howard, Virginia J.; Howard, George; Safford, Monika M.

doi:10.1161/strokeaha.109.561670

Cited by 49 publications

(42 citation statements)

References 36 publications

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Section: Discussionmentioning

confidence: 99%

“…We used current use of digoxin at baseline as a proxy for heart failure diagnosis similar to previous reports from REGARDS. 21 CHADS2 score (congestive heart failure; hypertension; age, ≥75 years; diabetes mellitus; and prior stroke) was calculated using 1 point for each category except for prior stroke, which was given 2 points. 22 Estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI equation (Chronic Kidney Disease Epidemiology Collaboration).…”

Section: Methodsmentioning

confidence: 99%

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Atrial Fibrillation and the Risk of Myocardial Infarction

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Atrial Fibrillation and the Risk of Myocardial Infarction

et al. 2014

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Section: Covariatesmentioning

confidence: 99%

“…Hence, we used current digoxin use as a proxy for heart failure similar to previous REGARDS articles. 21 It has been reported that digoxin use has a specificity of about 99% and a sensitivity of about 28% for the diagnosis of heart failure. 52 Data on the actual onset of AF were not available, and therefore we could not adjust for the time between AF onset and baseline visit.…”

Section: Limitationsmentioning

confidence: 99%

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Atrial Fibrillation and the Risk of Myocardial Infarction

Soliman

Safford

Muntner

et al. 2015

Survey of Anesthesiology

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IMPORTANCE-Myocardial infarction (MI) is an established risk factor for atrial fibrillation (AF). However, the extent to which AF is a risk factor for MI has not been investigated. OBJECTIVE-To Conflict of Interest Disclosures: None reported.Previous Presentation: An abstract of this article (No. 1151-49) was presented at the American College of Cardiology Annual 2013 Meeting; March 9, 2013; San Francisco, California. Additional Contributions:The authors thank the investigators, staff, and participants of the REGARDS study for their valuable contributions. A full list of participating REGARDS investigators and institutions can be found at http://www.regardsstudy.org. CONCLUSIONS AND RELEVANCE-AF is independently associated with an increased risk of incident MI, especially in women and blacks. These findings add to the growing concerns of the seriousness of AF as a public health burden: in addition to being a well-known risk factor for stroke, AF is also associated with increased risk of MI. NIH Public AccessAtrial fibrillation (AF) is a major public health problem owing to its increasing prevalence and strong association with morbidity and mortality. 1,2 Patients with AF have 4 to 5 times the risk of stroke and about double the risk of mortality compared with those without AF. [3][4][5][6] Myocardial infarction (MI) is an established risk factor for AF, 7 with AF occurring in 6% to 21% of patients with MI. 8 Conversely, sporadic cases of thromboembolic acute MI also have been reported in patients with AF, 9-16 and presence of AF during acute MI has been associated with increased risk of developing in-hospital reinfarction. 8 These findings suggest that AF could also be a risk factor for MI. However, evidence from population studies to support this assertion is lacking. Therefore, we examined the association between AF and risk of incident MI in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, 17 a large biracial population-based cohort study. MethodsThe study protocol was reviewed and approved by the participating institutions' institutional review boards. Informed consent was obtained initially on the telephone and subsequently in writing during an in-person evaluation.The goals and design of the REGARDS study have been published elsewhere. 17 Briefly, the study was designed to investigate causes of regional and racial disparities in stroke mortality, oversampling blacks and residents of the southeastern stroke belt region (North Carolina, South Carolina, Georgia, Alabama, Mississippi, Tennessee, Arkansas, and Louisiana). During the period from January 2003 to October 2007, participants (n = 30 239) were recruited from a commercially available list of residents using a combination of postal For this report, individuals with prevalent coronary heart disease (CHD) (self-reported history of MI or coronary revascularization procedure at baseline or evidence of prior MI on the baseline electrocardiogram [ECG]) were excluded. We also excluded participants with missing informatio...

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Interaction of heart failure and stroke: A clinical consensus statement of the ESC Council on Stroke, the Heart Failure Association (HFA) and the ESC Working Group on Thrombosis

Doehner,

Böhm,

Boriani

et al. 2023

European J of Heart Fail

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Heart failure (HF) is a major disease in our society that often presents with multiple comorbidities with mutual interaction and aggravation. The comorbidity of HF and stroke is a high risk condition that requires particular attention to ensure early detection of complications, efficient diagnostic workup, close monitoring, and consequent treatment of the patient. The bi‐directional interaction between the heart and the brain is inherent in the pathophysiology of HF where HF may be causal for acute cerebral injury, and ‐ in turn ‐ acute cerebral injury via imbalanced neural and neurovegetative control of cardiovascular regulation may induce or aggravate HF.The present document represents the consensus view of the ESC Council on Stroke, the Heart Failure Association and the ESC Working Group on Thrombosis to summarize current insights on pathophysiologic interactions of the heart and the brain in the comorbidity of HF and stroke. Principal aspects of diagnostic workup, pathophysiologic mechanisms, complications clinical management in acute conditions and in long‐term care of patients with the comorbidity are presented and state of the art clinical management and current evidence from clinical trials is discussed. Beside the physicians perspective, also the patients values and preferences are taken into account.Interdisciplinary cooperation of cardiologists, stroke specialists, other specialists and primary care physicians is pivotal to ensure optimal treatment in acute events and in continued long‐term treatment of these patients. Key consensus statements are presented in a concise overview on mechanistic insights, diagnostic workup, prevention and treatment to inform clinical acute and continued care of patients with the comorbidity of heart failure and stroke.

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Blood Pressure and Stroke in Heart Failure in the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study

Cited by 49 publications

References 36 publications

Atrial Fibrillation and the Risk of Myocardial Infarction

Atrial Fibrillation and the Risk of Myocardial Infarction

Atrial Fibrillation and the Risk of Myocardial Infarction

Interaction of heart failure and stroke: A clinical consensus statement of the ESC Council on Stroke, the Heart Failure Association (HFA) and the ESC Working Group on Thrombosis

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