Published Online
on January 5, 2006

A more recent version of this article appeared on February 1, 2006

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Submitted on June 12, 2005
Revised on September 18, 2005
Accepted on October 11, 2005

The Lifetime Risk of Stroke. Estimates From the Framingham Study

Sudha Seshadri MD^*; Alexa Beiser PhD; Margaret Kelly-Hayes RN, EdD; Carlos S. Kase MD; Rhoda Au PhD; William B. Kannel MD; and Philip A. Wolf MD

From the Departments of Neurology (S.S., M.K.H., C.S.K., R.A., P.A.W.) and Preventive Medicine (W.B.K.), School of Medicine, and the Department of Biostatistics, School of Public Health (A.B.), Boston University, Massachusetts.

^* To whom correspondence should be addressed. E-mail: Sudha.Seshadri{at}bmc.org.

Background and Purpose--The lifetime risk (LTR) of stroke has not been reported for the United States population; such data would assist public education and health planning.

Methods--Framingham Original cohort participants (n=4897) who were stroke- and dementia-free at 55 years of age were followed biennially for up to 51 years (115 146 person years). We estimated the sex-specific 10-, 20-, and 30-year risks and LTR of developing a stroke by baseline age and blood pressure (BP) and compared it with the risk of developing Alzheimer disease (AD).

Results--A total of 875 participants (522 women) developed a first-ever stroke; 749 (448 women) had an ischemic stroke. LTR of stroke was high and remained similar at ages 55, 65, and 75 years, approximating 1 in 5 for women and 1 in 6 for men. Participants with a normal BP (<120/80 mm Hg) had approximately half the LTR of stroke compared with those with high BP (140/90 mm Hg). The LTR of AD at age 65 (292 participants; 211 women) approximated 1 in 5 for women and 1 in 10 for men. The LTR of developing either stroke or dementia approximated 1 in 3 in both sexes.

Conclusion--The LTR of stroke in middle-aged adults is 1 in 6 or more, which is equal to or greater than the LTR of AD. Women had a higher risk because of longer life expectancy. BP is a significant determinant of the LTR of stroke, and promotion of normal BP levels in the community might be expected to substantially reduce this risk.

Key words: stroke • epidemiology • blood pressure • Alzheimer disease

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