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Lifetime Risk for Stroke

It’s at least as high as the lifetime risk for Alzheimer disease, according to Framingham Heart Study data.

These researchers estimated the lifetime risk for stroke among 4897 Framingham Heart Study participants who were stroke- and dementia-free at age 55. Maximum follow-up was 51 years for stroke and 29 years for dementia.

During follow-up, 875 participants (18%) had a first stroke (86% ischemic). The lifetime risk for stroke remained constant from age 55 to 75: about 1 in 5 for women and 1 in 6 for men. At age 85, the lifetime risk for stroke dropped to about 1 in 6 for women and 1 in 10 for men. Regardless of age, hypertensive participants had a consistently greater risk for stroke than did normotensive participants, even when users of antihypertensive drugs were excluded.

Four hundred participants (14%) developed dementia (73% with Alzheimer disease) during follow-up. Among people who reached age 65, the lifetime risk for AD was roughly 1 in 5 for women and 1 in 10 for men. These risks did not vary according to BP level.

Comment: These data document a lifetime risk for stroke in middle-aged adults at about 1 in 6, at least as high as the risk for developing Alzheimer disease. Given that hypertension was shown (once again) to be an important determinant of stroke risk, one would expect achieving normal BP to reduce the risk significantly, although this observational study did not address the effect of interventions.

— Joel M. Gore, MD

Published in Journal Watch Cardiology December 27, 2006

Citation(s):

Seshadri S et al. The lifetime risk of stroke: Estimates from the Framingham Study. Stroke 2006 Feb; 37:345-50.

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