Determining the Proportionality of Ischemic Stroke Risk Factors to Age.
Pubmed ID: 36826538
Pubmed Central ID: PMC9964102
Journal: Journal of cardiovascular development and disease
Publication Date: Jan. 23, 2023
Grants: 13/RC/2106_P2), 777107
Authors: Hunter E, Kelleher JD
Cite As: Hunter E, Kelleher JD. Determining the Proportionality of Ischemic Stroke Risk Factors to Age. J Cardiovasc Dev Dis 2023 Jan 23;10. (2).
Studies:
Abstract
While age is an important risk factor, there are some disadvantages to including it in a stroke risk model: age can dominate the risk score and lead to over- or under-predictions in some age groups. There is evidence to suggest that some of these disadvantages are due to the non-proportionality of other risk factors with age, e.g., risk factors contribute differently to stroke risk based on an individual's age. In this paper, we present a framework to test if risk factors are proportional with age. We then apply the framework to a set of risk factors using Framingham heart study data from the NHLBI Biologic Specimen and Data Repository Information Coordinating Center to determine if we can find evidence of non-proportionality. Using our framework, we find that a number of risk factors (diastolic blood pressure, total cholesterol, BMI, sex, high blood pressure treatment) may be non-proportional to age. This suggests that testing for the proportionality of risk factors with age should be something that is considered in stroke risk prediction modelling and traditional modelling methods may need to be adjusted to capture this non-proportionality.