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Age, female sex, history of hypertension, systolic blood pressure > 160 mm Hg, and prior stroke or transient ischemic attack were independently associated with increased stroke risk. Regular consumption of >/= 14 alcohol-containing drink s per week was associated with reduced stroke risk. Among SPAF III participants, estrogen hormone replacement therapy was associated with a higher risk of ischemic stroke. With the use of these variables, a risk stratification scheme for primary prevent ion separated participants into those with high (7.1%/y, 22% of the cohort), moderate (2.6%/y, 37% of the cohort), and low (0.9%/y, 41% of cohort) rates of stroke. Ischemic strokes in low-risk participants were less often disabling (P<0.001). Patients w ith AF who have high and low rates of stroke during treatment with aspirin can be identified. However, validation of our risk stratification scheme is necessary before it can be applied with confidence to clinical management. Postmenopausal estrogen rep lacement therapy and moderate alcohol consumption may additionally modify the risk of stroke in AF, but these findings require confirmation. |
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