Vertigo and stroke: a national database survey.

Objective: To investigate the association between vertigo and stroke in Taiwan using the Bureau of National Health Insurance research database.

Methods: Information on adult patients with an index vertigo attack in 2006 was retrieved from Bureau of National Health Insurance research database. All patients with specific diagnostic codes for vertigo were included. Occurrence of stroke during a 1-year follow-up period was identified. Risk factors for stroke were examined. Using χ test, t test, and a multilevel logistic regression model, patients with vertigo were categorized into stroke and nonstroke groups for comparative analyses. An age- and sex- matched control cohort was prepared for comparison.

Results: Patients with vertigo (n = 527,807) (mean age, 55.1 yr) accounted for 3.1% of the general Taiwanese adult population. The prevalence of stroke among vertigo patients of 0.5% (mean age, 67.8 yr) was slightly higher than that of the control group (0.3%; mean age, 72.3 yr; p < 0.0001). The types of stroke were ischemic (66.7%), nontypical (29.0%), and hemorrhage (4.3%). The prevalence of stroke increased with age (p < 0.001). Patients with vertigo had higher prevalence of comorbid conditions (p < 0.0001); those with diabetes mellitus, hypertension, dyslipidemia, coronary artery disease, or atrial fibrillation had a higher prevalence of stroke (p < 0.001). Hypertension was the most significant predictor of stroke (odds ratio, 3.77; 95% confidence interval, 3.36-4.23; p < 0.001).

Conclusion: Patients with vertigo had higher chance to develop stroke than the control group. Some strokes may initially manifest as peripheral vertigo, and some central vertigo may eventually evolve into a stroke. Middle aged male, diabetes, hypertension, dyslipidemia, coronary artery disease, and atrial fibrillation are risk factors for subsequent stroke in vertigo patients.