Department of Neurology, Boston University School of Medicine, 72 E Concord St, B602, Boston, MA 02118, USA.
Circulation. 2010 Mar 23;121(11):1304-12. doi: 10.1161/CIRCULATIONAHA.109.854240. Epub 2010 Mar 8.
Data relating parental history of stroke to stroke risk in offspring remain surprisingly inconsistent, largely because of heterogeneity of study design and the absence of verified, as opposed to historical, data on parental stroke status.
We determined whether prospectively verified parental occurrence of stroke increased incident stroke risk among offspring in a community-based sample by studying 3443 stroke-free Framingham offspring (53% female; mean age, 48+/-14 years) with verified parental stroke status (by 65 years of age) who attended the first, third, fifth, and/or seventh offspring examinations and were followed up for up to 8 years after each baseline examination. Over up to 11,029 such person-observation periods (77,534 person-years), we documented 106 parental strokes by 65 years of age and 128 offspring strokes (74 parental and 106 offspring strokes were ischemic). Using multivariable Cox models adjusted for age, sex, sibship, and baseline stroke risk factors, we observed that parental stroke, both all stroke generally and ischemic stroke specifically, was associated with an increased risk of incident stroke of the same type in the offspring (hazard ratio, 2.79; 95% confidence interval, 1.68 to 4.66; P<0.001 for all stroke; and hazard ratio, 3.15; 95% confidence interval, 1.69 to 5.88; P<0.001 for ischemic stroke). This was true for both maternal and paternal stroke.
Documented parental stroke by 65 years of age was associated with a 3-fold increase in risk of offspring stroke. This increased risk persisted after adjustment for conventional stroke risk factors. Thus, verified parental stroke may serve as a clinically useful risk marker of an individual's propensity to stroke.
有关父母中风史与子女中风风险的关系的数据仍然令人惊讶地不一致，主要原因是研究设计的异质性，以及缺乏经过验证的、而非历史数据的父母中风状况。
我们通过研究 3443 名无中风的弗雷明汉子女（53%为女性；平均年龄 48+/-14 岁），确定前瞻性验证的父母中风是否会增加子女中风的发病风险。这些子女的父母中风状况（至 65 岁时）已得到验证，他们参加了第一次、第三次、第五次和/或第七次子女检查，并在每次基线检查后最多 8 年进行随访。在多达 11029 个人观察期（77534 人年）中，我们记录了 106 名 65 岁以下父母的中风和 128 名子女的中风（74 名父母中风和 106 名子女中风为缺血性中风）。使用多变量 Cox 模型，根据年龄、性别、同胞关系和基线中风危险因素进行调整，我们观察到父母中风，无论是总体中风还是缺血性中风，与子女中风的发病风险增加有关（风险比为 2.79；95%置信区间为 1.68 至 4.66；所有中风 P<0.001；风险比为 3.15；95%置信区间为 1.69 至 5.88；缺血性中风 P<0.001）。这对母亲和父亲的中风都是如此。
65 岁以下父母中风的记录与子女中风风险增加 3 倍相关。这种增加的风险在调整了传统中风危险因素后仍然存在。因此，经过验证的父母中风可能是个体中风倾向的一个有用的临床风险标志物。
