Risk of Stroke in Patients with Heart Failure: A Population-Based 30-Year Cohort Study

Kasper Adelborg, Szimonetta Szépligeti, Jens Sundbøll, Erzsébet Horváth-Puhó, Victor W. Henderson, Anne Ording, Lars Pedersen, Henrik Toft Sørensen

Research output: Article

20 Citations (Scopus)


Background and Purpose - The long-term risk of specific stroke subtypes among heart failure patients is largely unknown. We examined short-term and long-term risk of ischemic stroke, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) in heart failure patients and in a general population comparison cohort. Methods - In this nationwide cohort study (1980-2012), we used Danish population-based medical registries to identify and follow (1) all patients hospitalized for the first time with heart failure and (2) a birth year-, sex-, and calendar year-matched general population comparison cohort. Age-, sex-, and comorbidity-adjusted stroke rate ratios were computed based on Cox regression analysis. Results - We included 289 353 patients with heart failure and 1 446 765 individuals from the general population in the analysis. One- and 5-year risks among heart failure patients were 1.4% and 3.9% for ischemic stroke, 0.2% and 0.5% for ICH, and 0.03% and 0.07% for SAH. The 30-day adjusted stroke rate ratio was increased markedly for ischemic stroke (5.08; 95% confidence interval, 4.58-5.63] and was also elevated for ICH (2.13; 95% confidence interval, 1.53-2.97) and SAH (3.52; 95% confidence interval, 1.54-8.08). Between 31 days and 30 years, risk of all stroke subtypes remained positively associated with heart failure (1.5- to 2.1-fold for ischemic stroke, 1.4- to 1.8-fold for ICH, and 1.1- to 1.7-fold for SAH) in comparison with the general population cohort. Conclusions - Heart failure was associated with increased short-term and long-term risk of all stroke subtypes, suggesting that heart failure is a potent and persistent risk factor for ischemic stroke, ICH, and SAH.

Original languageEnglish
Pages (from-to)1161-1168
Number of pages8
Issue number5
Publication statusPublished - máj. 1 2017


ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialised Nursing

Cite this

Adelborg, K., Szépligeti, S., Sundbøll, J., Horváth-Puhó, E., Henderson, V. W., Ording, A., Pedersen, L., & Sørensen, H. T. (2017). Risk of Stroke in Patients with Heart Failure: A Population-Based 30-Year Cohort Study. Stroke, 48(5), 1161-1168. https://doi.org/10.1161/STROKEAHA.116.016022