1. J Hypertens. 2009 May;27(5):1056-63.

Cardiovascular comorbidities and blood pressure control in stroke survivors.

Kesarwani M, Perez A, Lopez VA, Wong ND, Franklin SS.

Heart Disease Prevention Program, Division of Cardiology, Department ofMedicine, 
University of California, Irvine, California 92697-4101, USA

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 140 mmHg 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.

PMID: 19405168 [PubMed - indexed for MEDLINE]