Lifetime risk of stroke and dementia: current concepts, and estimates from the Framingham Study

Seshadri, Sudha; Wolf, Philip A.

doi:10.1016/s1474-4422(07)70291-0

Cited by 485 publications

(480 citation statements)

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“…A few reports have been published on the LTR of stroke from the Rotterdam Study (6-year follow-up), 5 the Framingham Study (450-year follow-up) 4 and the Suita Study (17-year follow-up); 6 and the LTR of stroke in our study was similar to the reported results from the these studies (about 20% for both men and women of 55 years of age). Male gender has been considered an important risk factor for stroke, 20 but the higher LTR in women of 55 years of age in the AHS has been attributed to the longer life span of women.…”

Section: Discussionsupporting

confidence: 89%

“…3 Lifetime risk (LTR) estimates, which represent risk of the disease of interest and adjust for competing risk of death from other causes, provide a simple conceptual basis for estimating absolute risk of developing a disease during the remainder of one's life. 4 Estimating the LTR in relation to known risk factors for stroke, such as hypertension, can help to highlight the magnitude and influence of these risk factors and the public health burden associated with them. Past estimates of the LTR of stroke in relation to known risk factors and the corresponding burden on the population, however, are limited.…”

Section: Introductionmentioning

confidence: 99%

“…Past estimates of the LTR of stroke in relation to known risk factors and the corresponding burden on the population, however, are limited. [4][5][6] The objectives of this study were to determine the LTR of stroke and to clarify long-term effects of BP levels at midlife in a Japanese population from the Adult Health Study (AHS) of atomic bomb survivors.…”

Section: Introductionmentioning

confidence: 99%

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Lifetime risk of stroke and impact of hypertension: estimates from the adult health study in Hiroshima and Nagasaki

et al. 2011

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Very few reports have been published on lifetime risk (LTR) of stroke by blood pressure (BP) group. This study included participants in the Radiation Effects Research Foundation Adult Health Study who have been followed up by biennial health examinations since 1958. We calculated the LTR of stroke for various BP-based groups among 7847 subjects who had not been diagnosed with stroke before the index age of 55 years using cumulative incidence analysis adjusting for competing risks. By 2003, 868 subjects had suffered stroke (512 (58.9%) were women and 542 (62.4%) experienced ischemic stroke). BP was a significant factor in determining risk of stroke for men and women, with distributions of cumulative risk for stroke significantly different across BP groups. The LTR of all-stroke for normotension (systolic BP/diastolic BP o120/80 mm Hg), prehypertension (120-139/80-89 mm Hg), stage1 hypertension (140-159/90-99 mm Hg) and stage 2 hypertension (4160/100 mm Hg) were 13.8-16.9-25.8-25.8% in men and 16.0-19.9-24.0-30.5% in women, respectively (Po0.001 among BP groups in both sexes). The estimates did not differ significantly (P¼0.16) between normotensive and prehypertensive subjects. One in five Japanese atomic bomb survivor subjects experienced stroke over their lifetime from the age of 55 years. Long-term stroke risks were elevated in those with hypertension (4140/90 mm Hg) at any of the index ages of 45, 55, 65 and 75 years.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Lifetime risk of stroke and impact of hypertension: estimates from the adult health study in Hiroshima and Nagasaki

et al. 2011

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“…Hypertension ICH, whereas current smoking, diabetes, apolipoproteins and cardiac causes are associated with ischaemic stroke (O'Donnel et al 2016). (Seshadri & Wolf 2007) Decreased dietary vitamin D intake (Brøndum-Jacobsen et al 2013) Cardiovascular diseases (Ferro 2003, O'Donnel et al 2010 Ethnic background (Howard et al 2016) Diet (O'Donnel et al 2010) Cervical artery stenosis (Autret et al 1987) Gender (Wolf et al 1992, Traylor et al 2012 Excessive alcohol consumption (O'Donnel et al 2010, Sundell et al 2008 Diabetes (O'Donnel et al 2010) Genetics (Traylor et al 2012) Illicit drug use (Fonseca & Ferro 2013) Dyslipidemia (O'Donnel et al 2010) Inadequate physical activity (Hu et al 2005, O'Donnel et al 2010 Hormonal treatment (Farquhar et al 2009) Increased salt intake (Strazzullo et al 2009) Hypertension (Kannel et al 1970) Low level of training and low socioeconomic position (Cesaroni et al 2009) Migrane (Spector et al 2010) Obesity (Strazzullo et al 2010) Periodontal disease (Lafon et al 2014) Psychological stress (Huang et al 2015) Prothrombotic state (Ferro et al 2010) Smoking (Shinton & Beevers 1989) Snoring and sleep apnea (Dyken & Im 2009) …”

Section: Risk Factorsmentioning

confidence: 99%

Stroke and the emergency medical services – enhancing performance within the chain of survival

Puolakka

2017

Acta Anaesthesiol Scand

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“…In this regard, lifetime risk is similar to life expectancy since it is also a hypothetically estimated risk index. Because shorter-term ageconditional risk estimates are less susceptible to changes in incidence, mortality rate changes in the longterm future, these estimates may better reflect the risk for a person alive and disease free in the study population today; thus, shorter-term age-conditional risk estimates are alleged to better reflect people's "true" risk experience 42) . In addition, they are more relevant to those approaching ages when CVD rates rise rapidly.…”

mentioning

confidence: 99%

Residual Lifetime Risk of Cardiovascular Diseases in Japan

Turin

Rumana

Okamura

2011

JAT

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Risk assessment of cardiovascular diseases (CVD) is shifting from the relative risk to an absolute risk approach. The residual lifetime risk (LTR), which provides an absolute risk assessment, is an epidemiologic measure that expresses the probability of someone of a given age and sex developing a disease condition during their remaining lifespan. The LTR estimation is important because it could be more easily comprehended by clinicians and patients. The LTR for CVD was not estimated for the Japanese population until recently, when the LTR of stroke and acute myocardial infarction (AMI) was reported. The reported LTR of stroke and AMI for middle-aged adults is substantial. The observed probabilities illustrated that approximately 1 in 5 men and women of middle age will suffer from a stroke in their remaining lifetime. On the other hand, approximately 1 in 6 men and 1 in 9 women of middle age will suffer from AMI in their remaining lifetime. Aaginst the backdrop of the aging population and worsening risk factor scenario, these estimates re-emphasize that CVD is a public health burden that requires preventive interventions. These estimates provide a means to communicate the absolute risk of CVD to the lay population, policy makers, as well as health service providers in predicting the disease burden of CVD. This easily comprehended knowledge can be used as an important index to assist in public health education and planning. J Atheroscler Thromb, 2011; 18:443-447.

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Lifetime risk of stroke and dementia: current concepts, and estimates from the Framingham Study

Cited by 485 publications

References 50 publications

Lifetime risk of stroke and impact of hypertension: estimates from the adult health study in Hiroshima and Nagasaki

Lifetime risk of stroke and impact of hypertension: estimates from the adult health study in Hiroshima and Nagasaki

Stroke and the emergency medical services – enhancing performance within the chain of survival

Residual Lifetime Risk of Cardiovascular Diseases in Japan

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