The lifetime risk of stroke: estimates from the Framingham Study.
OBJECTIVE
The lifetime risk (LTR) of stroke has not been reported for the United States population; such data would assist public education and health planning.


METHODS
Framingham Original cohort participants (n=4897) who were stroke- and dementia-free at 55 years of age were followed biennially for up to 51 years (115 146 person years). We estimated the sex-specific 10-, 20-, and 30-year risks and LTR of developing a stroke by baseline age and blood pressure (BP) and compared it with the risk of developing Alzheimer disease (AD).


RESULTS
A total of 875 participants (522 women) developed a first-ever stroke; 749 (448 women) had an ischemic stroke. LTR of stroke was high and remained similar at ages 55, 65, and 75 years, approximating 1 in 5 for women and 1 in 6 for men. Participants with a normal BP (<120/80 mm Hg) had approximately half the LTR of stroke compared with those with high BP (> or =140/90 mm Hg). The LTR of AD at age 65 (292 participants; 211 women) approximated 1 in 5 for women and 1 in 10 for men. The LTR of developing either stroke or dementia approximated 1 in 3 in both sexes.


CONCLUSIONS
The LTR of stroke in middle-aged adults is 1 in 6 or more, which is equal to or greater than the LTR of AD. Women had a higher risk because of longer life expectancy. BP is a significant determinant of the LTR of stroke, and promotion of normal BP levels in the community might be expected to substantially reduce this risk.
Seshadri
Sudha
S
Department of Neurology, School of Medicine, Boston University, Boston, MA 02118-2526, USA. Sudha.Seshadri@bmc.org
Beiser
Alexa
A
Kelly-Hayes
Margaret
M
Kase
Carlos S
CS
Au
Rhoda
R
Kannel
William B
WB
Wolf
Philip A
PA
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease; D001794:Blood Pressure; D015331:Cohort Studies; D015140:Dementia, Vascular / Q000473:pathology; D005260:Female; D006801:Humans; D008136:Longevity; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D012306:Risk; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology; D013997:Time Factors