A study has found that heart failure patients with a history of strokes are at a greater risk of depression, hospitalisation and death than those without such a history.

Heart failure and stroke have been identified as a lethal combination in research presented at EuroHeartCare 2017.  Dr. Chantal Ski from Melbourne University in Australia said that stroke is a common co-morbidity in patients with heart failure, yet little is known about the characteristics and outcomes of this patient population.Ski added that both are complex and debilitating diseases, so it seems likely that patients experiencing both stroke and heart failure will do worse but there is no evidence base to help guide clinical practice.

The team analysed 1,023 patients aged over 18 years, who were hospitalised for heart failure.Of these, 105 had a previous stroke and 918 did not.In the three-year follow-up study, the team found that heart failure and stroke patients had more comorbidities than those with heart failure alone. Heart failure patients with a history of stroke fared significantly worse than those with heart failure alone across all outcomes and all time points. They patients with both conditions died an average of five months earlier than those with heart failure alone. At 18 months, patients with heart failure and a history of stroke had a 1.5 to 2 times greater odds of hospitalisation or death than those with heart failure alone. 

Dr. Ski concluded that the patients with both heart failure and stroke need an interdisciplinary and integrated approach to their care in hospital and at home. Heart failure and stroke teams should work together to rationalise medications, ramp up the lifestyle and behavioural changes and include carers and family in any interventions.