Predicting 10-Year and Lifetime Stroke Risk in Chinese Population

Area of Science:

• Cardiovascular epidemiology
• Public health
• Biostatistics

Background:

• Stroke risk assessment is crucial for primary prevention.
• Existing tools inadequately predict stroke risk in Chinese populations.
• Need for individualized 10-year and lifetime stroke risk prediction.

Purpose of the Study:

• Develop and validate personalized stroke risk equations for Chinese adults.
• Incorporate data from four large Chinese cohorts.
• Enable precise 10-year and lifetime stroke risk assessment.

Main Methods:

• Utilized two prospective cohorts (21,320 participants) for equation development.
• Employed two independent cohorts (14,123 and 70,838 participants) for external validation.
• Compared 10-year risk equation performance against the Framingham Stroke Risk Profile for participants aged ≥55 years.

Main Results:

• Sex-specific 10-year stroke risk equations achieved C statistics of 0.810 for men and women.
• Lifetime stroke risk equations demonstrated C statistics around 0.800 with good calibration.
• Validated equations showed good agreement between observed and predicted stroke probabilities.
• Developed equations outperformed the Framingham Stroke Risk Profile in prediction capability.
• Lifetime risk assessment reclassified 5.7% of younger adults (35-49 years) to high-risk status.

Conclusions:

• A robust tool for predicting personalized 10-year and lifetime stroke risk in Chinese adults has been developed.
• This tool facilitates improved identification of high-risk individuals.
• The findings support enhanced community-based stroke prevention strategies in China.