Revised framingham stroke risk profile to reflect temporal trends

Carole Dufouil; Alexa Beiser; Leslie A. McLure; Philip A. Wolf; Christophe Tzourio; Virginia J. Howard; Andrew J. Westwood; Jayandra J. Himali; Lisa Sullivan; Hugo J. Aparicio; Margaret Kelly-Hayes; Karen Ritchie; Carlos S. Kase; Aleksandra Pikula; Jose R. Romero; Ralph B. D'Agostino; Cécilia Samieri; Ramachandran S. Vasan; Genevieve Chêne; George Howard; Sudha Seshadri

doi:10.1161/CIRCULATIONAHA.115.021275

Revised framingham stroke risk profile to reflect temporal trends

Carole Dufouil, Alexa Beiser, Leslie A. McLure, Philip A. Wolf, Christophe Tzourio, Virginia J. Howard, Andrew J. Westwood, Jayandra J. Himali, Lisa Sullivan, Hugo J. Aparicio, Margaret Kelly-Hayes, Karen Ritchie, Carlos S. Kase, Aleksandra Pikula, Jose R. Romero, Ralph B. D'Agostino, Cécilia Samieri, Ramachandran S. Vasan, Genevieve Chêne, George HowardSudha Seshadri

Research output: Contribution to journal › Article › peer-review

53 Scopus citations

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 X² 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.

Original language	English (US)
Pages (from-to)	1145-1159
Number of pages	15
Journal	Circulation
Volume	135
Issue number	12
DOIs	https://doi.org/10.1161/CIRCULATIONAHA.115.021275
State	Published - 2017
Externally published	Yes

Keywords

Cerebrovascular disorders
Cohort studies
Epidemiology
Primary prevention
Statistics [publication type]

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Physiology (medical)

Access to Document

10.1161/CIRCULATIONAHA.115.021275

Cite this

Dufouil, C., Beiser, A., McLure, L. A., Wolf, P. A., Tzourio, C., Howard, V. J., Westwood, A. J., Himali, J. J., Sullivan, L., Aparicio, H. J., Kelly-Hayes, M., Ritchie, K., Kase, C. S., Pikula, A., Romero, J. R., D'Agostino, R. B., Samieri, C., Vasan, R. S., Chêne, G., ... Seshadri, S. (2017). Revised framingham stroke risk profile to reflect temporal trends. Circulation, 135(12), 1145-1159. https://doi.org/10.1161/CIRCULATIONAHA.115.021275

Revised framingham stroke risk profile to reflect temporal trends. / Dufouil, Carole; Beiser, Alexa; McLure, Leslie A.; Wolf, Philip A.; Tzourio, Christophe; Howard, Virginia J.; Westwood, Andrew J.; Himali, Jayandra J.; Sullivan, Lisa; Aparicio, Hugo J.; Kelly-Hayes, Margaret; Ritchie, Karen; Kase, Carlos S.; Pikula, Aleksandra; Romero, Jose R.; D'Agostino, Ralph B.; Samieri, Cécilia; Vasan, Ramachandran S.; Chêne, Genevieve; Howard, George; Seshadri, Sudha.

In: Circulation, Vol. 135, No. 12, 2017, p. 1145-1159.

Research output: Contribution to journal › Article › peer-review

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, S 2017, 'Revised framingham stroke risk profile to reflect temporal trends', Circulation, vol. 135, no. 12, pp. 1145-1159. https://doi.org/10.1161/CIRCULATIONAHA.115.021275

Dufouil, Carole ; Beiser, Alexa ; McLure, Leslie A. ; Wolf, Philip A. ; Tzourio, Christophe ; Howard, Virginia J. ; Westwood, Andrew J. ; Himali, Jayandra J. ; Sullivan, Lisa ; Aparicio, Hugo J. ; Kelly-Hayes, Margaret ; Ritchie, Karen ; Kase, Carlos S. ; Pikula, Aleksandra ; Romero, Jose R. ; D'Agostino, Ralph B. ; Samieri, Cécilia ; Vasan, Ramachandran S. ; Chêne, Genevieve ; Howard, George ; Seshadri, Sudha. / Revised framingham stroke risk profile to reflect temporal trends. In: Circulation. 2017 ; Vol. 135, No. 12. pp. 1145-1159.

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title = "Revised framingham stroke risk profile to reflect temporal trends",

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 X2 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.",

keywords = "Cerebrovascular disorders, Cohort studies, Epidemiology, Primary prevention, Statistics [publication type]",

author = "Carole Dufouil and Alexa Beiser and McLure, {Leslie A.} and Wolf, {Philip A.} and Christophe Tzourio and Howard, {Virginia J.} and Westwood, {Andrew J.} and Himali, {Jayandra J.} and Lisa Sullivan and Aparicio, {Hugo J.} and Margaret Kelly-Hayes and Karen Ritchie and Kase, {Carlos S.} and Aleksandra Pikula and Romero, {Jose R.} and D'Agostino, {Ralph B.} and C{\'e}cilia Samieri and Vasan, {Ramachandran S.} and Genevieve Ch{\^e}ne and George Howard and Sudha Seshadri",

note = "Publisher Copyright: {\textcopyright} 2017 American Heart Association, Inc.",

year = "2017",

doi = "10.1161/CIRCULATIONAHA.115.021275",

language = "English (US)",

volume = "135",

pages = "1145--1159",

journal = "Circulation",

issn = "0009-7322",

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number = "12",

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T1 - Revised framingham stroke risk profile to reflect temporal trends

AU - Dufouil, Carole

AU - Beiser, Alexa

AU - McLure, Leslie A.

AU - Wolf, Philip A.

AU - Tzourio, Christophe

AU - Howard, Virginia J.

AU - Westwood, Andrew J.

AU - Himali, Jayandra J.

AU - Sullivan, Lisa

AU - Aparicio, Hugo J.

AU - Kelly-Hayes, Margaret

AU - Ritchie, Karen

AU - Kase, Carlos S.

AU - Pikula, Aleksandra

AU - Romero, Jose R.

AU - D'Agostino, Ralph B.

AU - Samieri, Cécilia

AU - Vasan, Ramachandran S.

AU - Chêne, Genevieve

AU - Howard, George

AU - Seshadri, Sudha

PY - 2017

Y1 - 2017

N2 - 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 X2 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.

AB - 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 X2 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.

KW - Cerebrovascular disorders

KW - Cohort studies

KW - Epidemiology

KW - Primary prevention

KW - Statistics [publication type]

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Revised framingham stroke risk profile to reflect temporal trends

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