Increased risk of stroke after the diagnosis of heart failure: is it a paradox of initiating heart failure treatment?
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We have read with great interest the article published by Alberts et al.  recently. In their cohort of Rotterdam study, they have evaluated the risk of stroke in heart failure patients. Briefly they have found that the risk of stroke is increased in the early phase after the diagnosis of heart failure and attenuates over the time.
In accordance with this report, Witt et al.  reported 17-fold increased risk of stroke within first month of heart failure diagnosis. On the other hand the underlying mechanism of increased risk of stroke after the diagnosis of heart failure has remained unknown. We believe that current literature underestimate or miss the effects of heart failure treatment. Any patient with the diagnosis of heart failure will receive the heart failure treatment. So the “1 month after diagnosis” term includes the treatment modalities as well. Those treatment alternatives are mainly preload reducing diuretics, after-load reducing drugs, namely angiotensin...