A random sample of 630 patients with heart failure was identified over a 20-year period, from 1979 through 1999, in this community-based study. Stroke risk in heart failure was compared with the risk in the general population using standard morbidity ratios. In the 30 days following a heart failure diagnosis, patients were at a 17-fold increased risk of stroke compared with the general population, and the risk remained elevated during the five years of follow-up.

"This research shows that preventing strokes has the potential to improve survival among patients with heart failure, and that stroke prevention should be among our key priorities for patients newly diagnosed with heart failure," says Veronique Roger, M.D., a cardiologist at Mayo Clinic in Rochester, Minn., who led the study.

The occurrence of a stroke among patients with heart failure resulted in a large increase in the risk of subsequent death compared with heart failure patients who remained stroke free.

Older people with a previous stroke or diabetes were more likely to experience a stroke, the research found.

In the past, studies have examined the incidence of stroke in heart failure, but findings were inconsistent and difficult to interpret, Dr. Roger says. While heart failure is a condition with a poor prognosis, the excess mortality from stroke had been unknown, she says.

Nearly 5 million Americans are living with heart failure, and 550,000 new cases are diagnosed each year, according to the American Heart Association.

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15-Nov-2005