Abstract:
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 χ2 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.
journal_name
Circulationjournal_title
Circulationauthors
Dufouil C,Beiser A,McLure LA,Wolf PA,Tzourio C,Howard VJ,Westwood AJ,Himali JJ,Sullivan L,Aparicio HJ,Kelly-Hayes M,Ritchie K,Kase CS,Pikula A,Romero JR,D'Agostino RB,Samieri C,Vasan RS,Chêne G,Howard G,Seshadri Sdoi
10.1161/CIRCULATIONAHA.115.021275subject
Has Abstractpub_date
2017-03-21 00:00:00pages
1145-1159issue
12eissn
0009-7322issn
1524-4539pii
CIRCULATIONAHA.115.021275journal_volume
135pub_type
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