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Revised Framingham Stroke Risk Profile to Reflect Temporal Trends.

Carole Dufouil1, Alexa Beiser1, Leslie A McLure1

  • 1From Inserm, Bordeaux Population Health Research Center, UMR 1219, Univ. Bordeaux, France (C.D., C.T., C.S., G.C.); ISPED, Univ. Bordeaux, France (C.D., C.S., G.C.); CHU de Bordeaux, Pole de sante publique, France (C.D., C.T., G.C.); Department of Neurology, School of Medicine (A.B., P.A.W., J.J.H., H.J.A., M.K.-H., C.S.K., A.P., J.R.R., S.S.), Department of Biostatistics, School of Public Health (A.B., L.S.), and Department of Mathematics (R.B.D.), Boston University, MA; National Heart, Lung, and Blood Institute's Framingham Heart Study, MA (A.B., P.A.W., A.J.W., J.J.H., H.J.A., M.K.-H., C.S.K., A.P., J.R.R., R.B.D., R.S.V., S.S.); Department of Biostatistics, Drexel University School of Public Health, Philadelphia, PA (L.A.M.); Departments of Epidemiology (V.J.H.) and Biostatistics (G.H.), School of Public Health, University of Alabama at Birmingham; and INSERM Unit 1061, Montpellier University, France (K.R.).

Circulation
|February 5, 2017
PubMed
Summary

A revised Framingham Stroke Risk Profile (FSRP) more accurately predicts stroke risk in contemporary populations. This updated model improves stroke risk assessment across diverse groups.

Keywords:
cerebrovascular disorderscohort studiesepidemiologyprimary preventionstatistics [publication type]

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Area of Science:

  • Epidemiology
  • Cardiovascular Disease Research
  • Biostatistics

Background:

  • Stroke incidence has declined due to risk factor management.
  • The Framingham Stroke Risk Profile (FSRP) requires updating to reflect current risk factor prevalence.
  • Evaluating a revised FSRP is crucial for contemporary stroke risk prediction.

Purpose of the Study:

  • To compare the predictive accuracy of a standard (old) FSRP with a revised (new) FSRP.
  • To validate the new FSRP in external cohorts (3C and REGARDS studies).
  • To assess the efficacy of updated FSRP in predicting 5- and 10-year stroke risks.

Main Methods:

  • Calculated old and new FSRP models using recent epoch-specific risk factor data.
  • Applied models to individuals aged ≥55 and ≥65 years to match external cohort age ranges.
  • Compared model performance in predicting stroke risk within the Framingham Heart Study (FHS) and external cohorts.

Main Results:

  • The new FSRP demonstrated superior stroke risk prediction compared to the old FSRP across all three samples (FHS, REGARDS, 3C).
  • Calibration statistics (χ²) indicated significantly better model fit for the new FSRP in both men and women.
  • In the REGARDS study, the new FSRP showed improved prediction accuracy in white participants compared to black participants.

Conclusions:

  • The updated FSRP provides a more accurate prediction of current stroke risks in large community samples.
  • The revised FSRP can serve as a foundation for investigating geographic and racial disparities in stroke risk.
  • This updated tool may facilitate the assessment of novel stroke risk factors.