期刊
CIRCULATION
卷 135, 期 12, 页码 1145-1159出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/CIRCULATIONAHA.115.021275
关键词
cerebrovascular disorders; cohort studies; epidemiology; primary prevention; statistics [publication type]
资金
- National Institute of Neurological Disorders and Stroke [5R01-NS017950]
- National Heart, Lung, and Blood Institute's Framingham Heart Study (National Institutes of Health/National Heart, Lung, and Blood Institute) [N01-HC-25195, HH-SN268201500001I]
- National Institute of Neurological Diseases and Stroke, National Institutes of Health [U01 NS041588]
- Department of Health and Human Services
- American Reinvestment and Recovery Act Supplement
- Institut National de la Sante et de la Recherche Medicale
- Victor Segalen-Bordeaux II University
- Fondation Plan Alzheimer
- Sanofi-Synthelabo Co
- Fondation pour la Recherche Medicale
- Caisse Nationale Maladie des Travailleurs Salaries
- Direction Generale de la Sante
- Haute Autorite de la Sante
- Institut National de Prevention et d'Education pour la Sante
- Conseils Regionaux of Bourgogne
- Fondation de France
- Ministry of Research-Institut National de la Sante et de la Recherche Medicale Program Cohortes et collections de donnees biologiques
- Mutuelle Generale de l'Education Nationale
- Institut de la Longevite
- Conseil Geneal de la Cote d'or
BACKGROUND: Age-adjusted stroke incidence has decreased over the past 50 years, likely as a result of changes in the prevalence and impact of various stroke risk factors. An updated version of the Framingham Stroke Risk Profile (FSRP) might better predict current risks in the FHS (Framingham Heart Study) and other cohorts. We compared the accuracy of the standard (old) and of a revised (new) version of the FSRP in predicting the risk of all-stroke and ischemic stroke and validated this new FSRP in 2 external cohorts, the 3C (3 Cities) and REGARDS (Reasons for Geographic and Racial Differences in Stroke) studies. METHODS: We computed the old FSRP as originally described and a new model that used the most recent epoch-specific risk factor prevalence and hazard ratios for individuals >= 55 years of age and for the subsample >= 65 years of age (to match the age range in REGARDS and 3C studies, respectively) and compared the efficacy of these models in predicting 5-and 10-year stroke risks. RESULTS: The new FSRP was a better predictor of current stroke risks in all 3 samples than the old FSRP (calibration.2 of new/old FSRP: in men: 64.0/12.1, 59.4/30.6, and 20.7/12.5; in women: 42.5/4.1, 115.4/90.3, and 9.8/6.5 in FHS, REGARDS, and 3C, respectively). In the REGARDS, the new FSRP was a better predictor among whites compared with blacks. CONCLUSIONS: A more contemporaneous, new FSRP better predicts current risks in 3 large community samples and could serve as the basis for examining geographic and racial differences in stroke risk and the incremental diagnostic utility of novel stroke risk factors.
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