Stroke, Vol 24, 1366-1371, Copyright © 1993 by American Heart Association
DK Kiely, PA Wolf, LA Cupples, AS Beiser and RH Myers
BACKGROUND AND PURPOSE: Family history is perceived to be an important risk
factor for stroke despite conflicting published data. We examined patterns
of familial aggregation of stroke among three generations using data from
the Framingham Study. METHODS: Cox proportional hazards analyses, adjusting
for known stroke risk factors, were used to examine familial concordance in
three groups: (1) members of the original Framingham cohort using reported
parental stroke death; (2) members of the Framingham Offspring Study and
their parents (members of the original Framingham Study); and (3) sibships
within the original Framingham cohort. RESULTS: We found no association
between stroke or transient ischemic attack among original cohort members
and their reported parental stroke death (n = 4933; relative risk [RR] =
1.07). Using verified cases of parental stroke or transient ischemic
attack, the Offspring analyses revealed that both paternal (n = 1762; RR =
2.4; 95% confidence interval [CI], 0.96 to 6.03) and maternal (n = 2074; RR
= 1.4; 95% CI, 0.60 to 3.25) histories were associated with an increased
risk. Parental history of coronary heart disease was strongly associated
with stroke or transient ischemic attack among Offspring Study members (RR
= 3.33; 95% CI, 1.27 to 8.72). Sibling history of stroke or transient
ischemic attack was not associated with stroke or transient ischemic attack
among original cohort members, although a non- statistically significant
increased risk associated with sibling history of atherothrombotic brain
infarction was observed (RR = 1.8; 95% CI, 0.68 to 4.94). CONCLUSIONS:
These analyses suggest that parental history of stroke may be a risk factor
for stroke. As more stroke or transient ischemic attack events develop
among the Offspring Study members, it will be valuable to reexamine these
associations.
ARTICLES
Familial aggregation of stroke. The Framingham Study
Department of Neurology, Boston University School of Medicine, MA 02118- 2394.
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