title: The CHADS2 Score to Predict Stroke Risk in the Absence of Atrial Fibrillation in Hypertensive Patients Aged 65 Years or Older.
abstract: OBJECTIVE
  The CHADS2 score is a proven, essential tool for estimating cardioembolic risk (mainly stroke) in patients with nonvalvular atrial fibrillation, with the purpose of determining the indication for anticoagulant therapy. In this study we analyzed the use of CHADS2 in hypertensive patients without known atrial fibrillation in a Mediterranean population.
  
  
  METHODS
  The study included 887 hypertensive patients aged 65 years or older without atrial fibrillation or anticoagulant therapy, who attended a medical consultation. Data on the patients' main risk factors, cardiovascular history, and medication were collected, basic laboratory analyses and electrocardiography were performed, and the CHADS2 score (heart failure, hypertension, age ≥ 75 years, diabetes mellitus, and previous stroke or transient ischemic attack) was calculated. A clinical follow-up was carried out, recording hospital admissions for a stroke or transient ischemic attack. The median duration of follow-up was 804 days.
  
  
  RESULTS
  Mean age was 72.5 (SD,5.7) years, 46.6% were men, 27.8% had diabetes, and 8.6% were smokers. During follow-up, 40 patients were hospitalized for a stroke or transient ischemic attack (4.5%). The event-free survival analysis showed significant differences according to the CHADS2 score (log rank test, P < .001). On multivariate analysis, smoking and CHADS2 ≥3 were independent predictors of stroke or transient ischemic attack.
  
  
  CONCLUSIONS
  The CHADS2 may be useful for estimating the risk of stroke or transient ischemic attack in hypertensive patients without known atrial fibrillation.
authors.affiliation: Servicio de Cardiología, Hospital General Universitario de Elche, Elche, Alicante, Spain. Electronic address: pedromorillas68@gmail.com.
authors.forename: Pedro
authors.initials: P
authors.lastname: Morillas
authors.affiliation: Unidad de Vigilancia de la Salud, Unión de Mutuas, Departamento de Medicina, Universitat Jaume I, Castellón, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Pallarés
authors.affiliation: Servicio de Cardiología, Hospital General de Valencia, Valencia, Spain.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Fácila
authors.affiliation: Centro de Salud Joaquín Benlloch, Valencia, Spain.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Llisterri
authors.affiliation: Servicio de Anestesia y Reanimación, Hospital General Universitario de Elche, Elche, Alicante, Spain.
authors.forename: María Eugenia
authors.initials: ME
authors.lastname: Sebastián
authors.affiliation: Servicio de Cardiología, Hospital General Universitario de Elche, Elche, Alicante, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Gómez
authors.affiliation: Servicio de Cardiología, Hospital General Universitario de Elche, Elche, Alicante, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Castilla
authors.affiliation: Servicio de Cardiología, Hospital General Universitario de Elche, Elche, Alicante, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Camarasa
authors.affiliation: Servicio de Cardiología, Hospital General Universitario de Elche, Elche, Alicante, Spain.
authors.forename: Miriam
authors.initials: M
authors.lastname: Sandin
authors.affiliation: Servicio de Cardiología, Hospital General Universitario de Elche, Elche, Alicante, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: García-Honrubia
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001281:Atrial Fibrillation / Q000453:epidemiology; D003925:Diabetic Angiopathies / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control; D018572:Disease-Free Survival; D042241:Early Diagnosis; D004562:Electrocardiography; D015444:Exercise / Q000502:physiology; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology; D002546:Ischemic Attack, Transient / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology / Q000517:prevention & control*
keywords: Accidente cerebrovascular; Coagulación; Coagulation; Hipertensión arterial sistémica; Stroke; Systemic arterial hypertension