Stroke symptoms and risk for incident coronary heart disease in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study

•Many adults without known cerebrovascular disease have had stroke symptoms.•Stroke symptoms are associated with coronary heart disease (CHD) incidence.•Screening for stroke symptoms can identify adults with high CHD risk.

BackgroundMany 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.MethodsWe 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 ≥ 45 years 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.ResultsOverall, 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 5.8 years. 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.ConclusionA history of stroke symptoms is associated with a higher incidence of CHD among black and white adults.