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Abstract WP190: Assessing The Performance Of The Framingham Stroke Risk Prediction Score In The REGARDS Cohort
Journal article   Peer reviewed

Abstract WP190: Assessing The Performance Of The Framingham Stroke Risk Prediction Score In The REGARDS Cohort

Leslie A McClure, Dawn O Kleindorfer, Mary Cushman, Elsayed Z Soliman, George Howard and Brett M Kissela
Stroke (1970), v 44(suppl_1)
Feb 2013
DOI: https://doi.org/10.1161/str.44.suppl_1.AWP190

Abstract

INTRODUCTION: The most well-known stroke risk score is the Framingham Stroke Risk Score (FSRS). However, the FSRS was developed during the higher stroke risk period of the 1990’s, and has not been validated for African Americans. Methods: Among participants in the Reasons for Geographic And Racial Differences in Stroke (REGARDS) cohort, we compared expected annualized stroke rates predicted from the FSRS to observed stroke rates overall and within strata defined by FSRS risk factors (age, sex, systolic blood pressure, use of antihypertensive medications, diabetes, smoking, atrial fibrillation, left ventricular hypertrophy and prevalent coronary heart disease). Results: Among 27,748 participants stroke-free at baseline, 715 stroke events occurred over 5.6 years of follow-up. FSRS-estimated incidence of stroke was 1.6 times higher than observed rates for black men, 1.9 times higher for white men (Table 1). This overestimation was consistent among most subgroups of FSRS factors including by categories of predicted FSRS level and blood pressure (Table 1). The overestimation was smaller for low predicted-risk blacks and among white females with higher SBP. Conclusions: While higher FSRS was associated with higher stroke risk, the FSRS overestimated observed stroke rates in this study, particularly in certain subgroups. This may be due to temporal declines in stroke rates, secular trends in prevention treatments, or differences in populations studied. More accurate estimates of event rates are critical for planning research, including clinical trials, and targeting health-care efforts.

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