TY - JOUR
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
N1 - Publisher Copyright:
© 2017 American Heart Association, Inc.
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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U2 - 10.1161/CIRCULATIONAHA.115.021275
DO - 10.1161/CIRCULATIONAHA.115.021275
M3 - Article
C2 - 28159800
AN - SCOPUS:85013055822
VL - 135
SP - 1145
EP - 1159
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 12
ER -