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Is the Population Detected by Screening in China Truly at High Risk of Stroke?

Yuan Wang1, Jing Wang1, Juan Cheng1

  • 1Department of Epidemiology and Health Statistics, School of Public Health, Tianjin Medical University, Tianjin, China; Collaborative Innovation Center of Chronic disease prevention and control, Tianjin Medical University, Tianjin, China.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|April 14, 2018
PubMed

Insights

A new health risk appraisal (HRA) model offers a more accurate stroke risk assessment than the Chinese Stroke Screening and Prevention Project (CSSPP) by quantitatively evaluating individual risk factors for stroke.

Area of Science:

  • Cardiovascular disease epidemiology
  • Public health
  • Biostatistics

Background:

  • The Chinese Stroke Screening and Prevention Project (CSSPP) identifies high-risk stroke patients based on a threshold of 3 or more risk factors.
  • This method does not quantitatively assess individual stroke risk, potentially leading to inefficiencies in high-risk group detection.

Purpose of the Study:

  • To develop and evaluate a Health Risk Appraisal (HRA) model for quantitatively assessing individual stroke risk.
  • To compare the efficiency of the HRA model with the CSSPP screening strategy.

Main Methods:

  • Pooled odds ratios for 8 stroke risk factors were used to develop a 5-year stroke risk prediction model.
  • The HRA model's predictions were compared against the CSSPP's risk classification.

Main Results:

  • The average 5-year stroke risk was 5.81‰, with higher risks observed in men and increasing risk with more factors.
  • CSSPP identified 22.2% as high-risk, but the HRA model reclassified individuals with fewer risk factors as high-risk if their calculated risk exceeded 4.0%.
  • Notably, 15.9% of hypertension patients and 14.3% of diabetes patients classified as low-risk by CSSPP were identified as high-risk by the HRA model.

Conclusions:

  • Individual stroke risk factors have varying impacts on overall risk.
  • An HRA model, by considering the relative risk of each factor, can improve the efficiency of identifying high-risk individuals for stroke prevention.
Abstract

Keywords:
ChineseStrokerisk assessmentrisk factorsscreening

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