(Stroke. 1997;28:1908-1912.)
© 1997 American Heart Association, Inc.
Articles |
Familial History of Stroke and Stroke Risk
The Family Heart Study
From the Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill (D.L., C.P., G.H.); Section of Preventive Medicine and Epidemiology, University Hospital, Boston, Mass (R.M.); Cardiovascular Genetics, University of Utah, Salt Lake City (S.H.); Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis (E.S.); Department of Public Health Sciences, Bowman-Gray School of Medicine, Winston-Salem, NC (G.B.); and Division of Biostatistics, Washington University, St Louis, Mo (M.P.).
Background and Purpose Although familial history of stroke is generally perceived to be an important marker of stroke risk, very few epidemiological studies have been published to address this hypothesis. We sought to examine whether familial history of stroke is associated with the prevalence of stroke in the Family Heart Study, a National Heart, Lung, and Blood Institute–supported multicenter study of the familial, genetic, and nongenetic determinants of cardiovascular disease in populations.
Methods The personal and familial histories of stroke were assessed in 3168 individuals (probands) who were at least 45 years old and 29 325 of their first-degree relatives with the use of a standardized questionnaire.
Results The age-, ethnicity-, and sex-adjusted stroke prevalences were 4.8%, 4.9%, and 3.9% in probands with a positive familial, paternal, and maternal history of stroke, respectively, in comparison with 2.0% in probands without any positive familial history (P<.01). The age-, ethnicity-, and sex-adjusted odds ratios (95% confidence interval) of stroke were 2.00 (1.13, 3.54) for a positive paternal and 1.41 (0.80, 2.50) for a positive maternal history of stroke. Additional statistical adjustment for the proband's history of elevated cholesterol level, cigarette smoking status, history of coronary heart disease, hypertension, and diabetes did not alter the associations. A similar pattern was seen for African Americans and European Americans.
Conclusions The increased risk of stroke among persons with a positive familial history of stroke compared with those without a familial history of stroke is consistent with the expression of genetic susceptibility, a shared environment, or both in the etiology of stroke.
Key Words: epidemiology • genetics • risk factors
This article has been cited by other articles:
 |
|
 |
|
  M. A. Ikram, S. Seshadri, J. C. Bis, M. Fornage, A. L. DeStefano, Y. S. Aulchenko, S. Debette, T. Lumley, A. R. Folsom, E. G. van den Herik, et al. Genomewide Association Studies of Stroke N. Engl. J. Med., April 23, 2009; 360(17): 1718 - 1728. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Debette and S. Seshadri Genetics of Atherothrombotic and Lacunar Stroke Circ Cardiovasc Genet, April 1, 2009; 2(2): 191 - 198. [Full Text] [PDF]
|
|
|
|
 |
|
 J. Putaala, A. J. Metso, T. M. Metso, N. Konkola, Y. Kraemer, E. Haapaniemi, M. Kaste, and T. Tatlisumak Analysis of 1008 Consecutive Patients Aged 15 to 49 With First-Ever Ischemic Stroke: The Helsinki Young Stroke Registry Stroke, April 1, 2009; 40(4): 1195 - 1203. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Howden, E. Liu, L. Miller-DeGraff, H. L. Keener, C. Walker, J. A. Clark, P. H. Myers, D. C. Rouse, T. Wiltshire, and S. R. Kleeberger The genetic contribution to heart rate and heart rate variability in quiescent mice Am J Physiol Heart Circ Physiol, July 1, 2008; 295(1): H59 - H68. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Touze and P. M. Rothwell Sex Differences in Heritability of Ischemic Stroke: A Systematic Review and Meta-Analysis Stroke, January 1, 2008; 39(1): 16 - 23. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. F. Meschia, L. D. Case, B. B. Worrall, R. D. Brown Jr, T. G. Brott, M. Frankel, S. Silliman, S. S. Rich, and for the Ischemic Stroke Genetics Study Group Family history of stroke and severity of neurologic deficit after stroke Neurology, October 24, 2006; 67(8): 1396 - 1402. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. B. Goldstein, R. Adams, M. J. Alberts, L. J. Appel, L. M. Brass, C. D. Bushnell, A. Culebras, T. J. DeGraba, P. B. Gorelick, J. R. Guyton, et al. Primary Prevention of Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council: Cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group: The American Academy of Neurology affirms the value of this guideline. Circulation, June 20, 2006; 113(24): e873 - e923. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. B. Goldstein, R. Adams, M. J. Alberts, L. J. Appel, L. M. Brass, C. D. Bushnell, A. Culebras, T. J. DeGraba, P. B. Gorelick, J. R. Guyton, et al. Primary Prevention of Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council: Cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group: The American Academy of Neurology affirms the value of this guideline. Stroke, June 1, 2006; 37(6): 1583 - 1633. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Nilsson-Ardnor, P.-G. Wiklund, P. Lindgren, A. K. Nilsson, T. Janunger, S. A. Escher, B. Hallbeck, B. Stegmayr, K. Asplund, and D. Holmberg Linkage of Ischemic Stroke to the PDE4D Region on 5q in a Swedish Population Stroke, August 1, 2005; 36(8): 1666 - 1671. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Bevan, L. Porteous, M. Sitzer, and H.S. Markus Phosphodiesterase 4D Gene, Ischemic Stroke, and Asymptomatic Carotid Atherosclerosis Stroke, May 1, 2005; 36(5): 949 - 953. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. F. Meschia, T. G. Brott, and R. D. Brown Jr Genetics of Cerebrovascular Disorders Mayo Clin. Proc., January 1, 2005; 80(1): 122 - 132. [Abstract] [PDF]
|
|
|
|
 |
|
 J. P. Casas, A. D. Hingorani, L. E. Bautista, and P. Sharma Meta-analysis of Genetic Studies in Ischemic Stroke: Thirty-two Genes Involving Approximately 18 000 Cases and 58 000 Controls Arch Neurol, November 1, 2004; 61(11): 1652 - 1661. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. J. DeGraba Immunogenetic Susceptibility of Atherosclerotic Stroke: Implications on Current and Future Treatment of Vascular Inflammation Stroke, November 1, 2004; 35(11_suppl_1): 2712 - 2719. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. M. Murabito, B.-H. Nam, R. B. D'Agostino Sr., D. M. Lloyd-Jones, C. J. O'Donnell, and P. W.F. Wilson Accuracy of Offspring Reports of Parental Cardiovascular Disease History: The Framingham Offspring Study Ann Intern Med, March 16, 2004; 140(6): 434 - 440. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Flossmann, U. G.R. Schulz, and P. M. Rothwell Systematic Review of Methods and Results of Studies of the Genetic Epidemiology of Ischemic Stroke Stroke, January 1, 2004; 35(1): 212 - 227. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Tentschert, S. Greisenegger, R. Wimmer, W. Lang, and W. Lalouschek Association of Parental History of Stroke With Clinical Parameters in Patients With Ischemic Stroke or Transient Ischemic Attack Stroke, September 1, 2003; 34(9): 2114 - 2119. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. F. Meschia, E. J. Atkinson, P. C. O'Brien, T. G. Brott, R. D. Brown Jr, and J. Hardy Familial Clustering of Stroke According to Proband Age at Onset of Presenting Ischemic Stroke Stroke, July 1, 2003; 34 (7): e89 - e91. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Novak, A. Chowdhary, B. Farrar, H. Nagaraja, J. Braun, R. Kanard, P. Novak, and A. Slivka Altered cerebral vasoregulation in hypertension and stroke Neurology, May 27, 2003; 60(10): 1657 - 1663. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Hassan, P. C. Sham, and H. S. Markus Planning genetic studies in human stroke: Sample size estimates based on family history data Neurology, May 28, 2002; 58(10): 1483 - 1488. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Bak, D. Gaist, S. H. Sindrup, A. Skytthe, and K. Christensen Genetic Liability in Stroke: A Long-Term Follow-Up Study of Danish Twins Stroke, March 1, 2002; 33(3): 769 - 774. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. B. Worrall, D. T. Chen, and J. F. Meschia Ethical and Methodological Issues in Pedigree Stroke Research Stroke, June 1, 2001; 32(6): 1242 - 1249. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G.J. Hademenos, M.J. Alberts, I. Awad, M. Mayberg, T. Shephard, A. Jagoda, R.E. Latchaw, H.W. Todd, K. Viste, R. Starke, et al. Advances in the genetics of cerebrovascular disease and stroke Neurology, April 24, 2001; 56(8): 997 - 1008. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. B. Goldstein, R. Adams, K. Becker, C. D. Furberg, P. B. Gorelick, G. Hademenos, M. Hill, G. Howard, V. J. Howard, B. Jacobs, et al. Primary Prevention of Ischemic Stroke : A Statement for Healthcare Professionals From the Stroke Council of the American Heart Association Circulation, January 2, 2001; 103(1): 163 - 182. [Full Text] [PDF]
|
|
|
|
|
|
L. B. Goldstein, R. Adams, K. Becker, C. D. Furberg, P. B. Gorelick, G. Hademenos, M. Hill, G. Howard, V. J. Howard, B. Jacobs, et al. Primary Prevention of Ischemic Stroke : A Statement for Healthcare Professionals From the Stroke Council of the American Heart Association Stroke, January 1, 2001; 32(1): 280 - 299. [Full Text] [PDF]
|
|
|
|
 |
|
 A. Hassan and H. S. Markus Genetics and ischaemic stroke Brain, September 1, 2000; 123(9): 1784 - 1812. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. C. Morrison, M. Fornage, D. Liao, and E. Boerwinkle Parental History of Stroke Predicts Subclinical But Not Clinical Stroke : The Atherosclerosis Risk in Communities Study Stroke, September 1, 2000; 31(9): 2098 - 2102. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Carlsson, M. Orho-Melander, J. Hedenbro, P. Almgren, and L. C. Groop The T 54 Allele of the Intestinal Fatty Acid-Binding Protein 2 Is Associated with a Parental History of Stroke J. Clin. Endocrinol. Metab., August 1, 2000; 85(8): 2801 - 2804. [Abstract] [Full Text]
|
|
|
|
|
|
A. Elbaz, O. Poirier, T. Moulin, F. Chedru, F. Cambien, and P. Amarenco Association Between the Glu298Asp Polymorphism in the Endothelial Constitutive Nitric Oxide Synthase Gene and Brain Infarction Stroke, July 1, 2000; 31(7): 1634 - 1639. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Carlsson, Y. Wessman, P. Almgren, and L. Groop High Levels of Nonesterified Fatty Acids Are Associated With Increased Familial Risk of Cardiovascular Disease Arterioscler Thromb Vasc Biol, June 1, 2000; 20(6): 1588 - 1594. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. F. Meschia, T. G. Brott, F. E. Chukwudelunzu, J. Hardy, R. D. Brown Jr, I. Meissner, L. J. Hall, E. J. Atkinson, and P. C. O'Brien Verifying the Stroke-Free Phenotype by Structured Telephone Interview Stroke, May 1, 2000; 31(5): 1076 - 1080. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Boerwinkle, P. A. Doris, and M. Fornage Field of Needs : The Genetics of Stroke Circulation, January 26, 1999; 99(3): 331 - 333. [Full Text] [PDF]
|
|