Association Between Gastrointestinal Symptoms and Stroke Prevalence rate and Post-Stroke Mortality in Hypertensive Individuals: Evidence from a National Cohort

BackgroundStroke is a leading cause of mortality, and hypertension is a key risk factor. Gastrointestinal (GI) symptoms are frequent in stroke patients and may affect prevalence and prognosis via the brain-gut axis, but their role in hypertensive populations is unclear. MethodsWe analyzed data from 12,987 US adults in the National Health and Nutrition Examination Survey (NHANES) (2005-2010). Stroke history was self-reported, and GI symptoms (chronic constipation or diarrhoea) were categorized using the Bristol Stool Scale. Weighted multivariable logistic regression was employed to evaluate the relationship between GI symptoms and stroke in individuals with hypertension, while Cox models were utilized to examine their influence on cardiovascular and all-cause mortality in hypertensive stroke survivors, fully adjusting for covariates. ResultsAmong hypertensive individuals, diarrhea (OR = 1.65, 95% CI: 1.08-2.54) and overall gastrointestinal symptoms (OR = 1.68, 95% CI: 1.20-2.35) were significantly associated with an increased prevalence rate of stroke after full adjustment. In the overall population, diarrhea (OR = 1.60, 95% CI: 1.00-2.53) and gastrointestinal symptoms (OR = 1.55, 95% CI: 1.12-2.13) also showed significant associations with stroke. In hypertensive stroke survivors, constipation was associated with an increased risk of cardiovascular mortality (HR = 2.15, 95% CI: 1.07-4.31). ConclusionsIn this study, gastrointestinal symptoms were found to be associated with stroke prevalence in hypertensive adults. Notably, constipation was prospectively linked to an increased risk of cardiovascular mortality in hypertensive stroke survivors. These findings suggest a gut-brain interaction and highlight gut healths importance for prognosis in high-risk populations.