Cardiovascular comorbidities and blood pressure control in  stroke survivors.
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.


CONCLUSIONS
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.
Kesarwani
Manoj
M
Heart Disease Prevention Program, Division of Cardiology, Department ofMedicine, University of California, Irvine, California 92697-4101, USA
Perez
Alejandro
A
Lopez
Victor A
VA
Wong
Nathan D
ND
Franklin
Stanley S
SS
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology*; D002908:Chronic Disease; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000150:complications / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D007674:Kidney Diseases / Q000150:complications / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D009749:Nutrition Surveys; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D012907:Smoking / Q000009:adverse effects; D020521:Stroke / Q000150:complications / Q000453:epidemiology*; D017741:Survivors; D014481:United States / Q000453:epidemiology
D000959:Antihypertensive Agents