title: Peak Systolic Velocity Measurements with Transcranial Doppler Ultrasound Is a Predictor of Incident Stroke among the General Population in China.
abstract: OBJECTIVE
  It is necessary to develop an effective and low-cost screening tool for identifying Chinese people at high risk of stroke. Transcranial Doppler ultrasound (TCD) is a powerful predictor of stroke in the pediatric sickle cell disease population, as demonstrated in the STOP trial. Our study was conducted to determine the prediction value of peak systolic velocities as measured by TCD on subsequent stroke risk in a prospective cohort of the general population from Beijing, China.
  
  
  METHODS
  In 2002, a prospective cohort study was conducted among 1392 residents from 11 villages of the Shijingshan district of Beijing, China. The cohort was scheduled for follow up with regard to incident stroke in 2005, 2007, and 2012 by a study team comprised of epidemiologists, nurses, and physicians. Univariate and multivariate Cox proportional hazard regression models were used to determine the factors associated with incident stroke.
  
  
  RESULTS
  Participants identified by TCD criteria as having intracranial stenosis had a 3.6-fold greater risk of incident stroke (hazard ratio (HR) 3.57, 95% confidence interval (CI) 1.86-6.83, P<0.01) than those without TCD evidence of intracranial stenosis. The association remained significant in multivariate analysis (HR 2.53, 95% CI 1.31-4.87) after adjusting for other risk factors or confounders. Older age, cigarette smoking, hypertension, and diabetes mellitus remained statistically significant as risk factors after controlling for other factors.
  
  
  CONCLUSIONS
  The study confirmed the screening value of TCD among the general population in urban China. Increasing the availability of TCD screening may help identify subjects as higher risk for stroke.
authors: Peking University Clinical Research Institute, Xueyuan Rd 38#, Haidian Dist, Beijing, 100191, China.
authors: Hai-Bo
authors: HB
authors: Wang
authors: Department of Neurology, Duke University Medicine Center, Durham, North Carolina, 27710, United States of America.
authors: Daniel T
authors: DT
authors: Laskowitz
authors: Department of Neurology, Duke University Medicine Center, Durham, North Carolina, 27710, United States of America.
authors: Jodi A
authors: JA
authors: Dodds
authors: Peking University Clinical Research Institute, Xueyuan Rd 38#, Haidian Dist, Beijing, 100191, China.
authors: Gao-Qiang
authors: GQ
authors: Xie
authors: The George Institute for Global Health at Peking University Health Science Center, Beijing, 100191, China.
authors: Pu-Hong
authors: PH
authors: Zhang
authors: Department of Neurology, Peking University First Hospital, Beijing, 100034, China.
authors: Yi-Ning
authors: YN
authors: Huang
authors: Department of Neurology, Peking Union Medical Hospital, Beijing, 100730, China.
authors: Bo
authors: B
authors: Wang
authors: Peking University Clinical Research Institute, Xueyuan Rd 38#, Haidian Dist, Beijing, 100191, China.|The George Institute for Global Health at Peking University Health Science Center, Beijing, 100191, China.|Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, 100191, China.
authors: Yang-Feng
authors: YF
authors: Wu
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D002560:Cerebrovascular Circulation; D002681:China; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000473:pathology; D016019:Survival Analysis; D013599:Systole; D017585:Ultrasonography, Doppler, Transcranial