How do American stroke risk functions perform in a Western European population?
OBJECTIVE
We evaluated the predictive performance of the stroke risk functions from the Framingham and the Cardiovascular Health Study in a population-based study in The Netherlands.


METHODS
We assessed how well the functions could estimate the number of strokes in the Rotterdam Study, and how well they could discriminate between high- and low-risk persons.


RESULTS
Both functions predicted the number of stroke cases reasonably well, except in persons with a predicted 5-year risk higher than 5%, where they overestimated the risk. The area under the receiver operator characteristic curve was 0.75 (95% confidence interval, 0.71-0.78) for both functions.


CONCLUSIONS
Stroke risk functions developed in US populations predict the number of strokes reasonably well in elderly Western European persons at low or modest risk for stroke. The functions can be a useful tool to discriminate between persons at high or low risk for stroke.
Department of Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands.
Zoltán
Z
Vokó
Monika
M
Hollander
Peter J
PJ
Koudstaal
Albert
A
Hofman
Monique M B
MM
Breteler
D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications / Q000517:prevention & control; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000517:prevention & control; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000209:etiology*; D014481:United States