title: Family history of stroke and cardiovascular health in a national cohort.
abstract: BACKGROUND
  We investigated the association between family history of stroke (FHS) and Life's Simple 7 (LS7), a public health metric defined by the American Heart Association.
  
  
  METHODS
  Reasons for Geographic and Racial Differences in Stroke is a national population-based cohort of 30,239 blacks and whites, aged 45 years or older, sampled from the US population between 2003 and 2007. Data were collected by telephone, mail questionnaires, and in-home examinations. FHS was defined as any first-degree relative with stroke. Levels of the LS7 components (total cholesterol, blood pressure, fasting glucose, physical activity, diet, smoking, and body mass index) were each coded as poor (0 points), intermediate (1 point), or ideal (2 points) health. Ordinal logistic regression was used to model the data.
  
  
  RESULTS
  Among 20,567 subjects with complete LS7 and FHS data, there were 7702 (37%) participants with an FHS. The mean age of the participants was 64 years. The mean (± standard deviation) overall LS7 score was lower for blacks (6.5 ± 2.0) than that of whites (7.6 ± 2.1). FHS was associated with poorer levels of physiological factors, particularly high blood pressure (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.07-1.19) and inversely associated with behaviors such as smoking (OR, .92; 95% CI, .85-.99).
  
  
  CONCLUSIONS
  Our results suggest that screening for FHS can provide an opportunity for earlier detection and management of modifiable risk factors.
authors.affiliation: Department of Epidemiology, Emory University, Atlanta, Georgia; Department of Family and Preventive Medicine, Emory University, Atlanta, Georgia. Electronic address: akulshr@emory.edu.
authors.forename: Ambar
authors.initials: A
authors.lastname: Kulshreshtha
authors.affiliation: Department of Epidemiology, Emory University, Atlanta, Georgia; Department of Medicine, Emory University, Atlanta, Georgia.
authors.forename: Viola
authors.initials: V
authors.lastname: Vaccarino
authors.affiliation: Department of Medicine, Emory University, Atlanta, Georgia.
authors.forename: Abhinav
authors.initials: A
authors.lastname: Goyal
authors.affiliation: Department of Epidemiology, Emory University, Atlanta, Georgia.
authors.forename: William
authors.initials: W
authors.lastname: McClellan
authors.affiliation: Department of Neurology, Emory University, Atlanta, Georgia.
authors.forename: Fadi
authors.initials: F
authors.lastname: Nahab
authors.affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Virginia J
authors.initials: VJ
authors.lastname: Howard
authors.affiliation: Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Judd
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044383:Black People; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000235:genetics*; D004032:Diet; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking; D020521:Stroke / Q000453:epidemiology* / Q000235:genetics*; D011795:Surveys and Questionnaires; D014481:United States; D044465:White People; D001741:Black or African American
keywords: Cohort Study; Family history of stroke; Life Simple 7; Racial Differences; risk factors