Stroke, Vol 25, 40-43, Copyright © 1994 by American Heart Association
RB D'Agostino, PA Wolf, AJ Belanger and WB Kannel
BACKGROUND AND PURPOSE--We sought to modify existing sex-specific health
risk appraisal functions (profile functions) for the prediction of first
stroke that better assess the effects of the use of antihypertensive
medication. METHODS--Health risk appraisal functions were previously
developed from the Framingham Study cohort. These functions were Cox
proportional hazards regression models relating age, systolic blood
pressure, diabetes mellitus, cigarette smoking, prior cardiovascular
disease, atrial fibrillation, left ventricular hypertrophy by
electrocardiogram, and the use of antihypertensive medication to the
occurrence of stroke. Closer examination of the data indicated that
antihypertensive therapy effect is present only for systolic blood
pressures between 110 and 200 mm Hg. Adjustments to the regressions to
better fit the observed data were developed and tested for statistical
significance and goodness-of-fit of the model residuals. RESULTS--Modified
functions more consistent with the data were developed, and, from these,
tables to evaluate 10-year risk of first stroke were computed.
CONCLUSIONS--The stroke profile can be used for evaluation of the risk of
stroke and suggestion of risk factor modification to reduce risk. The
effect of antihypertensive therapy in the evaluation of stroke risk can now
be better evaluated.
ARTICLES
Stroke risk profile: adjustment for antihypertensive medication. The Framingham Study
Department of Mathematics, Boston University, MA 02215.
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