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Revised Framingham Stroke Risk Profile to Reflect Temporal Trends.

TitleRevised Framingham Stroke Risk Profile to Reflect Temporal Trends.
Publication TypeJournal Article
Year of Publication2017
AuthorsDufouil, 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
JournalCirculation
Volume135
Issue12
Pagination1145-1159
Date Published2017 Mar 21
ISSN1524-4539
KeywordsAged, Cohort Studies, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Predictive Value of Tests, Prevalence, Proportional Hazards Models, Risk Factors, Stroke
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 χ 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.

DOI10.1161/CIRCULATIONAHA.115.021275
Alternate JournalCirculation
PubMed ID28159800
PubMed Central IDPMC5504355
Grant ListR01 NS017950 / NS / NINDS NIH HHS / United States
R01 AG054076 / AG / NIA NIH HHS / United States
HHSN268201500001C / HL / NHLBI NIH HHS / United States
R01 AG008122 / AG / NIA NIH HHS / United States
HHSN268201500001I / HL / NHLBI NIH HHS / United States
R01 AG033040 / AG / NIA NIH HHS / United States
N01HC25195 / HL / NHLBI NIH HHS / United States
R03 AG048180 / AG / NIA NIH HHS / United States