[OP.3C.09] RECURRENT ROTATIONAL VERTIGO IS A PREDICTOR OF STROKE IN HYPERTENSIVE PATIENTS. (September 2017)

• Record Type: Journal Article
• Authors: Courand, P.Y.; Serraille, M.; Milon, H.; Berge, C.; Harbaoui, B.; Lantelme, P.
• Is Part Of: Journal of hypertension. Volume 35(2017)Supplement 2
• Publication Date: 2017-09
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000523064.25181.d8
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Vertigo is associated with hypertension but also with numerous other aetiologies. The aims of the present study were 1) to describe the characteristics and the clinical correlates of vertigo in a large cohort of hypertensive patients and 2) to test the prognostic value of this symptom for all-cause, cardiovascular, and stroke mortality. Design and method: 1716 hypertensive individuals were questioned at baseline with a standardized questionnaire. They were categorized first, according to the absence or the presence of at least twice vertigo during the past year. When the symptom was present, patients were classified according to 4 subgroups: rotational, hypotension-like, seasickness and other vertigo. Results: Baseline characteristics of our cohort were: mean age 45 years, 61% of men, mean office blood pressure 175/104 mmHg, 13% of diabetes, mean eGFR 82.4 mL/min and 20% of previous cardiovascular event. 33.9% (N = 581) of patients experienced frequent episodes of vertigo. Multiple regression analysis demonstrated that vertigo was predicted by age, gender (women) and coronary artery disease. After 30 years of follow-up, we observed 956 deaths of whom 508 from cardiovascular cause (including strokes) and 114 acute strokes. As shown by Kaplan-Meier curves (Figure), frequent vertigos were predictor of stroke mortality (p = 0.001) but not both for all-cause and cardiovascular mortality (p = 0.371 and p = 0.233, respectively). In the multivariate Cox regression model adjusted for cardiovascular risk factors, secondary prevention and treatment, patients with vertigo have a similar risk for stroke mortality than those without (hazard ratio 1.19; 95% CI [0.81–1.77]). Analyzing in turn, the different subgroups of vertigo, rotational vertigo predicted stroke death after adjustment (hazard ratio 2.08; 95% CI [1.22–3.55]), while the association was not observed with hypotension-like vertigo (hazard ratio 1.00; 95% CI [0.55–1.83]), seasickness vertigo (hazard ratio 1.12; 95% CI [0.72–1.76]) and other vertigo (hazard ratio 0.88; 95% CI [0.48–1.61]). Figure. No caption available. Conclusions: Recurrent vertigos in hypertensive patients are associated at baseline with gender, age and coronary artery disease. Hypertensive patients complaining with frequent rotational vertigos must be carefully followed over years because of their increase risk of stroke mortality.