Skip to main content
Journal cover image

Comparison of risk scores for the prediction of stroke in African Americans: Findings from the Jackson Heart Study.

Publication ,  Journal Article
Foraker, RE; Greiner, M; Sims, M; Tucker, KL; Towfighi, A; Bidulescu, A; Shoben, AB; Smith, S; Talegawkar, S; Blackshear, C; Wang, W ...
Published in: Am Heart J
July 2016

BACKGROUND: Evidence from existing cohort studies supports the prediction of incident coronary heart disease and stroke using 10-year cardiovascular disease (CVD) risk scores and the American Heart Association/American Stroke Association's cardiovascular health (CVH) metric. METHODS: We included all Jackson Heart Study participants with complete scoring information at the baseline study visit (2000-2004) who had no history of stroke (n = 4,140). We used Kaplan-Meier methods to calculate the cumulative incidence of stroke and used Cox models to estimate hazard ratios and 95% CIs for stroke according to CVD risk and CVH score. We compared the discrimination of the 2 models according to the Harrell c index and plotted predicted vs observed stroke risk calibration plots for each of the 2 models. RESULTS: The median age of the African American participants was 54.5 years, and 65% were female. The cumulative incidence of stroke increased across worsening categories of CVD risk and CVH. A 1-unit increase in CVD risk increased the hazard of stroke (1.07, 1.06-1.08), whereas each 1-unit increase in CVH corresponded to a decreased hazard of stroke (0.76, 0.69-0.83). As evidenced by the c statistics, the CVH model was less discriminating than the CVD risk model (0.59 [0.55-0.64] vs 0.79 [0.76-0.83]). CONCLUSIONS: Both scores were associated with incident stroke in a dose-response fashion; however, the CVD risk model was more discriminating than the CVH model. The CVH score may still be preferable for its simplicity in application to broad patient populations and public health efforts.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

July 2016

Volume

177

Start / End Page

25 / 32

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • Stroke
  • Risk Factors
  • Risk Assessment
  • Proportional Hazards Models
  • Middle Aged
  • Male
  • Kaplan-Meier Estimate
  • Incidence
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Foraker, R. E., Greiner, M., Sims, M., Tucker, K. L., Towfighi, A., Bidulescu, A., … O’Brien, E. (2016). Comparison of risk scores for the prediction of stroke in African Americans: Findings from the Jackson Heart Study. Am Heart J, 177, 25–32. https://doi.org/10.1016/j.ahj.2016.04.007
Foraker, Randi E., Melissa Greiner, Mario Sims, Katherine L. Tucker, Amytis Towfighi, Aurelian Bidulescu, Abigail B. Shoben, et al. “Comparison of risk scores for the prediction of stroke in African Americans: Findings from the Jackson Heart Study.Am Heart J 177 (July 2016): 25–32. https://doi.org/10.1016/j.ahj.2016.04.007.
Foraker RE, Greiner M, Sims M, Tucker KL, Towfighi A, Bidulescu A, et al. Comparison of risk scores for the prediction of stroke in African Americans: Findings from the Jackson Heart Study. Am Heart J. 2016 Jul;177:25–32.
Foraker, Randi E., et al. “Comparison of risk scores for the prediction of stroke in African Americans: Findings from the Jackson Heart Study.Am Heart J, vol. 177, July 2016, pp. 25–32. Pubmed, doi:10.1016/j.ahj.2016.04.007.
Foraker RE, Greiner M, Sims M, Tucker KL, Towfighi A, Bidulescu A, Shoben AB, Smith S, Talegawkar S, Blackshear C, Wang W, Hardy NC, O’Brien E. Comparison of risk scores for the prediction of stroke in African Americans: Findings from the Jackson Heart Study. Am Heart J. 2016 Jul;177:25–32.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

July 2016

Volume

177

Start / End Page

25 / 32

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • Stroke
  • Risk Factors
  • Risk Assessment
  • Proportional Hazards Models
  • Middle Aged
  • Male
  • Kaplan-Meier Estimate
  • Incidence