The lifetime risk of stroke - Estimates from the Framingham Study
The lifetime risk of stroke - Estimates from the Framingham Study
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DOI：
10.1161/01.str.0000199613.38911.b2
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发表时间：
2006-02-01
期刊：
影响因子：
8.3
通讯作者：
Wolf, PA
中科院分区：
文献类型：
--
作者：
Seshadri, S;Beiser, A;Wolf, PA
背景与目的——美国人群的中风终生风险（LTR）尚未见报道；此类数据将有助于公众教育和卫生规划。
方法——对弗雷明汉原始队列中55岁时无中风和痴呆的参与者（n = 4897）进行了长达51年（115146人年）的每两年一次的随访。我们根据基线年龄和血压（BP）估算了发生中风的性别特异性10年、20年和30年风险以及终生风险，并将其与患阿尔茨海默病（AD）的风险进行了比较。
结果——共有875名参与者（522名女性）发生了首次中风；749人（448名女性）为缺血性中风。中风的终生风险较高，在55岁、65岁和75岁时相似，女性约为五分之一，男性约为六分之一。血压正常（≤140/90 mmHg）的参与者终生风险低于血压升高（>140/90 mmHg）的参与者。65岁时阿尔茨海默病的终生风险（292名参与者；211名女性）女性约为五分之一，男性约为十分之一。男女发生中风或痴呆的终生风险均约为三分之一。
结论——中年成年人中风的终生风险为六分之一或更高，等于或大于阿尔茨海默病的终生风险。由于预期寿命较长，女性风险更高。血压是中风终生风险的重要决定因素，在社区中促进正常血压水平可能会大幅降低这种风险。
Background and Purpose-The lifetime risk (LTR) of stroke has not been reported for the United States population; such data would assist public education and health planning.Methods-Framingham Original cohort participants (n=4897) who were stroke- and dementia-free at 55 years of age were followed biennially for up to 51 years (115 146 person years). We estimated the sex-specific 10-, 20-, and 30-year risks and LTR of developing a stroke by baseline age and blood pressure ( BP) and compared it with the risk of developing Alzheimer disease (AD).Results-A total of 875 participants (522 women) developed a first-ever stroke; 749 (448 women) had an ischemic stroke. LTR of stroke was high and remained similar at ages 55, 65, and 75 years, approximating 1 in 5 for women and 1 in 6 for men. Participants with a normal BP (= 140/90 mm Hg). The LTR of AD at age 65 (292 participants; 211 women) approximated 1 in 5 for women and 1 in 10 for men. The LTR of developing either stroke or dementia approximated 1 in 3 in both sexes.Conclusion-The LTR of stroke in middle-aged adults is 1 in 6 or more, which is equal to or greater than the LTR of AD. Women had a higher risk because of longer life expectancy. BP is a significant determinant of the LTR of stroke, and promotion of normal BP levels in the community might be expected to substantially reduce this risk.