Seshadri Sudha, Beiser Alexa, Kelly-Hayes Margaret, Kase Carlos S, Au Rhoda, Kannel William B, Wolf Philip A
Department of Neurology, School of Medicine, Boston University, Boston, MA 02118-2526, USA.
Stroke. 2006 Feb;37(2):345-50. doi: 10.1161/01.STR.0000199613.38911.b2. Epub 2006 Jan 5.
The lifetime risk (LTR) of stroke has not been reported for the United States population; such data would assist public education and health planning.
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).
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 (> or =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.
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.
美国人群的终生卒中风险（LTR）尚未见报道；此类数据将有助于公众教育和健康规划。
弗雷明汉原队列研究的参与者（n = 4897），55岁时无卒中及痴呆，每两年随访一次，最长随访51年（115146人年）。我们根据基线年龄和血压（BP）估算了发生卒中的性别特异性10年、20年和30年风险及终生风险，并将其与患阿尔茨海默病（AD）的风险进行比较。
共有875名参与者（522名女性）发生首次卒中；749名（448名女性）为缺血性卒中。卒中的终生风险很高，在55岁、65岁和75岁时保持相似，女性约为五分之一，男性约为六分之一。血压正常（<120/80 mmHg）的参与者发生卒中的终生风险约为高血压（≥140/90 mmHg）参与者的一半。65岁时AD的终生风险（292名参与者；211名女性）女性约为五分之一，男性约为十分之一。发生卒中和痴呆的终生风险在两性中均约为三分之一。
中年成年人卒中的终生风险为六分之一或更高，等于或高于AD的终生风险。由于预期寿命较长，女性风险更高。血压是卒中终生风险的重要决定因素，预计在社区推广正常血压水平可能会大幅降低这种风险。
