Can Self-Reported Strokes Be Used to Study Stroke Incidence and Risk Factors? Evidence From the Health and Retirement Study
Can Self-Reported Strokes Be Used to Study Stroke Incidence and Risk Factors? Evidence From the Health and Retirement Study
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DOI：
10.1161/strokeaha.108.529479
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发表时间：
2009-03-01
期刊：
影响因子：
8.3
通讯作者：
Avendano, Mauricio
中科院分区：
文献类型：
--
作者：
Glymour, M. Maria;Avendano, Mauricio
背景和目的--大多数卒中发病率研究使用的是地理区域性（社区）样本，很少有全国性的数据来源。这样的样本排除了对背景风险因素的研究，但国家样本经常只收集自我报告的中风。我们检查是否发病率估计从临床验证的研究是一致的估计从全国代表性的美国样本评估自我报告stroke.Methods -健康和退休研究（HRS）参与者（n=17 056）年龄50岁以上的自我或代理人报告的首次中风（1293事件）从1998年至2006年（平均6.8年）。我们比较了种族、性别和年龄分层的发病率与先前在医学证实的卒中的主要地理定位研究中记录的发病率。我们还研究了心血管危险因素的影响估计在HRS是可比的临床证实stroks.Results研究中报告的加权首次中风发病率为10.0事件/1000人年。白人的总年龄分层发病率大多与其他地方报告的发病率相当，并没有系统性的高或低。然而，在HRS的黑人中，发病率通常高于先前报告的发病率。HRS估计值与心血管健康研究中报告的估计值最具可比性。发病率大约每10岁增加一倍，男性和黑人的发病率更高。在人口统计学调整后，所有的危险因素都能预测白人的中风发病率。吸烟，高血压，糖尿病和心脏病预测事件中风在blacks.Conclusions -已知的危险因素和中风发病率之间的关联进行了验证，在HRS，这表明误报是非系统性的。HRS可为卒中监测和经典及相关危险因素的检查提供有价值的数据。（中风。2009; 40：873-879）。
Background and Purpose - Most stroke incidence studies use geographically localized (community) samples with few national data sources available. Such samples preclude research on contextual risk factors, but national samples frequently collect only self-reported stroke. We examine whether incidence estimates from clinically verified studies are consistent with estimates from a nationally representative US sample assessing self-reported stroke.Methods - Health and Retirement Study (HRS) participants (n=17 056) age 50+ years were followed for self- or proxy-reported first stroke (1293 events) from 1998 to 2006 (average, 6.8 years). We compared incidence rates by race, sex, and age strata with those previously documented in leading geographically localized studies with medically verified stroke. We also examined whether cardiovascular risk factor effect estimates in HRS are comparable to those reported in studies with clinically verified strokes.Results - The weighted first-stroke incidence rate was 10.0 events/1000 person-years. Total age-stratified incidence rates in whites were mostly comparable with those reported elsewhere and were not systematically higher or lower. However, among blacks in HRS, incidence rates generally appeared higher than those previously reported. HRS estimates were most comparable with those reported in the Cardiovascular Health Study. Incidence rates approximately doubled per decade of age and were higher in men and blacks. After demographic adjustment, all risk factors predicted stroke incidence in whites. Smoking, hypertension, diabetes, and heart disease predicted incident stroke in blacks.Conclusions - Associations between known risk factors and stroke incidence were verified in HRS, suggesting that misreporting is nonsystematic. HRS may provide valuable data for stroke surveillance and examination of classical and contextual risk factors. (Stroke. 2009; 40: 873-879.)