Revised Framingham Stroke Risk Profile to Reflect Temporal Trends
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 St...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 2017-03, Vol.135 (12), p.1145-1159 |
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| creator | 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 |
| description | 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 FSRPin men64.0/12.1, 59.4/30.6, and 20.7/12.5; in women42.5/4.1, 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. |
| doi_str_mv | 10.1161/CIRCULATIONAHA.115.021275 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5504355</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1865528636</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5995-826c6da0f36186ebc1464c1a28dd5d0110da148c0468a112c894659e8c4e0c513</originalsourceid><addsrcrecordid>eNqNUcFuEzEQtRCIpoVfQMuNyxaP1-N4DyCtIkojRRSF9Gy53tlmiXcd7E0r_h5XKRW9cRrNzJv3nuYx9h74OYCCj4vlenG9ajbLq2_NZZNneM4FiDm-YDNAIUuJVf2SzTjndTmvhDhhpyn9zK2q5vianQgNWGvOZ6xZ012fqC0uoh368XZrh-LHFMOOinWfdsX3GLreUzGFYk2dJzcVGxr2IVpfbCKNbXrDXnXWJ3r7WM_Y9cWXzeKyXF19XS6aVemwrrHUQjnVWt5VCrSiGwdSSQdW6LbFlgPw1oLUjkulLYBwupYKa9JOEncI1Rn7fOTdH24Gah2NUzZh9rEfbPxtgu3N883Yb81tuDOIXFaImeDDI0EMvw6UJjP0yZH3dqRwSCbbQhRaVSpD6yPUxZBSpO5JBrh5iMA8jyDP0BwjyLfv_vX5dPn35xnw6Qi4D36imHb-cE_RbMn6afsfAn8A7OiXFQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1865528636</pqid></control><display><type>article</type><title>Revised Framingham Stroke Risk Profile to Reflect Temporal Trends</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>American Heart Association</source><source>Journals@Ovid Complete</source><creator>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</creator><creatorcontrib>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</creatorcontrib><description>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 FSRPin men64.0/12.1, 59.4/30.6, and 20.7/12.5; in women42.5/4.1, 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.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/CIRCULATIONAHA.115.021275</identifier><identifier>PMID: 28159800</identifier><language>eng</language><publisher>United States: by the American College of Cardiology Foundation and the American Heart Association, Inc</publisher><subject>Aged ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Predictive Value of Tests ; Prevalence ; Proportional Hazards Models ; Risk Factors ; Stroke - diagnosis ; Stroke - epidemiology ; Stroke - mortality</subject><ispartof>Circulation (New York, N.Y.), 2017-03, Vol.135 (12), p.1145-1159</ispartof><rights>2017 by the American College of Cardiology Foundation and the American Heart Association, Inc.</rights><rights>2017 American Heart Association, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5995-826c6da0f36186ebc1464c1a28dd5d0110da148c0468a112c894659e8c4e0c513</citedby><cites>FETCH-LOGICAL-c5995-826c6da0f36186ebc1464c1a28dd5d0110da148c0468a112c894659e8c4e0c513</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,3674,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28159800$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dufouil, Carole</creatorcontrib><creatorcontrib>Beiser, Alexa</creatorcontrib><creatorcontrib>McLure, Leslie A</creatorcontrib><creatorcontrib>Wolf, Philip A</creatorcontrib><creatorcontrib>Tzourio, Christophe</creatorcontrib><creatorcontrib>Howard, Virginia J</creatorcontrib><creatorcontrib>Westwood, Andrew J</creatorcontrib><creatorcontrib>Himali, Jayandra J</creatorcontrib><creatorcontrib>Sullivan, Lisa</creatorcontrib><creatorcontrib>Aparicio, Hugo J</creatorcontrib><creatorcontrib>Kelly-Hayes, Margaret</creatorcontrib><creatorcontrib>Ritchie, Karen</creatorcontrib><creatorcontrib>Kase, Carlos S</creatorcontrib><creatorcontrib>Pikula, Aleksandra</creatorcontrib><creatorcontrib>Romero, Jose R</creatorcontrib><creatorcontrib>D’Agostino, Ralph B</creatorcontrib><creatorcontrib>Samieri, Cécilia</creatorcontrib><creatorcontrib>Vasan, Ramachandran S</creatorcontrib><creatorcontrib>Chêne, Genevieve</creatorcontrib><creatorcontrib>Howard, George</creatorcontrib><creatorcontrib>Seshadri, Sudha</creatorcontrib><title>Revised Framingham Stroke Risk Profile to Reflect Temporal Trends</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>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 FSRPin men64.0/12.1, 59.4/30.6, and 20.7/12.5; in women42.5/4.1, 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.</description><subject>Aged</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Predictive Value of Tests</subject><subject>Prevalence</subject><subject>Proportional Hazards Models</subject><subject>Risk Factors</subject><subject>Stroke - diagnosis</subject><subject>Stroke - epidemiology</subject><subject>Stroke - mortality</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNUcFuEzEQtRCIpoVfQMuNyxaP1-N4DyCtIkojRRSF9Gy53tlmiXcd7E0r_h5XKRW9cRrNzJv3nuYx9h74OYCCj4vlenG9ajbLq2_NZZNneM4FiDm-YDNAIUuJVf2SzTjndTmvhDhhpyn9zK2q5vianQgNWGvOZ6xZ012fqC0uoh368XZrh-LHFMOOinWfdsX3GLreUzGFYk2dJzcVGxr2IVpfbCKNbXrDXnXWJ3r7WM_Y9cWXzeKyXF19XS6aVemwrrHUQjnVWt5VCrSiGwdSSQdW6LbFlgPw1oLUjkulLYBwupYKa9JOEncI1Rn7fOTdH24Gah2NUzZh9rEfbPxtgu3N883Yb81tuDOIXFaImeDDI0EMvw6UJjP0yZH3dqRwSCbbQhRaVSpD6yPUxZBSpO5JBrh5iMA8jyDP0BwjyLfv_vX5dPn35xnw6Qi4D36imHb-cE_RbMn6afsfAn8A7OiXFQ</recordid><startdate>20170321</startdate><enddate>20170321</enddate><creator>Dufouil, Carole</creator><creator>Beiser, Alexa</creator><creator>McLure, Leslie A</creator><creator>Wolf, Philip A</creator><creator>Tzourio, Christophe</creator><creator>Howard, Virginia J</creator><creator>Westwood, Andrew J</creator><creator>Himali, Jayandra J</creator><creator>Sullivan, Lisa</creator><creator>Aparicio, Hugo J</creator><creator>Kelly-Hayes, Margaret</creator><creator>Ritchie, Karen</creator><creator>Kase, Carlos S</creator><creator>Pikula, Aleksandra</creator><creator>Romero, Jose R</creator><creator>D’Agostino, Ralph B</creator><creator>Samieri, Cécilia</creator><creator>Vasan, Ramachandran S</creator><creator>Chêne, Genevieve</creator><creator>Howard, George</creator><creator>Seshadri, Sudha</creator><general>by the American College of Cardiology Foundation and the American Heart Association, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170321</creationdate><title>Revised Framingham Stroke Risk Profile to Reflect Temporal Trends</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5995-826c6da0f36186ebc1464c1a28dd5d0110da148c0468a112c894659e8c4e0c513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Predictive Value of Tests</topic><topic>Prevalence</topic><topic>Proportional Hazards Models</topic><topic>Risk Factors</topic><topic>Stroke - diagnosis</topic><topic>Stroke - epidemiology</topic><topic>Stroke - mortality</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dufouil, Carole</creatorcontrib><creatorcontrib>Beiser, Alexa</creatorcontrib><creatorcontrib>McLure, Leslie A</creatorcontrib><creatorcontrib>Wolf, Philip A</creatorcontrib><creatorcontrib>Tzourio, Christophe</creatorcontrib><creatorcontrib>Howard, Virginia J</creatorcontrib><creatorcontrib>Westwood, Andrew J</creatorcontrib><creatorcontrib>Himali, Jayandra J</creatorcontrib><creatorcontrib>Sullivan, Lisa</creatorcontrib><creatorcontrib>Aparicio, Hugo J</creatorcontrib><creatorcontrib>Kelly-Hayes, Margaret</creatorcontrib><creatorcontrib>Ritchie, Karen</creatorcontrib><creatorcontrib>Kase, Carlos S</creatorcontrib><creatorcontrib>Pikula, Aleksandra</creatorcontrib><creatorcontrib>Romero, Jose R</creatorcontrib><creatorcontrib>D’Agostino, Ralph B</creatorcontrib><creatorcontrib>Samieri, Cécilia</creatorcontrib><creatorcontrib>Vasan, Ramachandran S</creatorcontrib><creatorcontrib>Chêne, Genevieve</creatorcontrib><creatorcontrib>Howard, George</creatorcontrib><creatorcontrib>Seshadri, Sudha</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dufouil, Carole</au><au>Beiser, Alexa</au><au>McLure, Leslie A</au><au>Wolf, Philip A</au><au>Tzourio, Christophe</au><au>Howard, Virginia J</au><au>Westwood, Andrew J</au><au>Himali, Jayandra J</au><au>Sullivan, Lisa</au><au>Aparicio, Hugo J</au><au>Kelly-Hayes, Margaret</au><au>Ritchie, Karen</au><au>Kase, Carlos S</au><au>Pikula, Aleksandra</au><au>Romero, Jose R</au><au>D’Agostino, Ralph B</au><au>Samieri, Cécilia</au><au>Vasan, Ramachandran S</au><au>Chêne, Genevieve</au><au>Howard, George</au><au>Seshadri, Sudha</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Revised Framingham Stroke Risk Profile to Reflect Temporal Trends</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2017-03-21</date><risdate>2017</risdate><volume>135</volume><issue>12</issue><spage>1145</spage><epage>1159</epage><pages>1145-1159</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><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 FSRPin men64.0/12.1, 59.4/30.6, and 20.7/12.5; in women42.5/4.1, 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.</abstract><cop>United States</cop><pub>by the American College of Cardiology Foundation and the American Heart Association, Inc</pub><pmid>28159800</pmid><doi>10.1161/CIRCULATIONAHA.115.021275</doi><tpages>15</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Circulation (New York, N.Y.), 2017-03, Vol.135 (12), p.1145-1159 |
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| language | eng |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; American Heart Association; Journals@Ovid Complete |
| subjects | Aged Cohort Studies Female Follow-Up Studies Humans Kaplan-Meier Estimate Male Middle Aged Predictive Value of Tests Prevalence Proportional Hazards Models Risk Factors Stroke - diagnosis Stroke - epidemiology Stroke - mortality |
| title | Revised Framingham Stroke Risk Profile to Reflect Temporal Trends |
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