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Premature parental stroke raises offspring’s risk
11 March 2010
MedWire News: People’s risk for stroke is more than doubled if one of their parents had a stroke before the age of 65 years, show data from the Framingham Study.
“This simple measure might prove to be a useful risk marker in clinical risk prediction,” say Sudha Seshadri (Boston University School of Medicine, Massachusetts, USA) and co-workers.
They suggest the measure could also improve the power of stroke risk scores.
During up to 8 years of follow-up, 128 of 3443 Framingham offspring participants, aged an average of 48 years, suffered stroke. Also, 106 of their parents had already suffered a documented stroke before the age of 65 years.
Offspring with premature parental stroke were slightly younger than those with stroke-free parents, at 50 versus 51 years. They had higher systolic blood pressure, and were more likely to have diabetes and to be current smokers. Thus, they had higher Framingham Stroke Risk Profile (FSRP) scores, with an average 10-year stroke risk of 0.045 compared with 0.038 among those with stroke-free parents.
Yet after accounting for these and other variables, offspring were still 2.21 times more likely to suffer stroke if either parent had suffered a stroke. Risk was elevated 2.47 fold for ischemic stroke and 2.60 fold for atherothrombotic brain infarction.
Stroke risk appeared to be slightly higher in people whose fathers had premature stroke than in those whose mothers had premature stroke, the team notes in the journal Circulation.
Seshadri et al note that family history is not a modifiable risk factor, but add that the effect of parental stroke history was strongest for offspring in the top two quintiles of FSRP score.
“Thus attention to control of modifiable risk factors for stroke prevention, particularly in the presence of a positive familial occurrence (or history) of premature stroke, is strongly supported by these data,” they say.
The researchers add that the observed effect is “unlikely to be due to shared environmental risk factors alone because the increased risk persisted after adjustment for levels of conventional stroke risk factors.”
They say: “The Framingham study is currently relating 550K genome-wide association data to the risk for incident stroke; the observed strong familial aggregation suggests that such efforts should prove fruitful.”
