[Association between different types of first-degree relatives' stroke history and the incidence risk of stroke: A prospective cohort study].

Abstract

Objective: To assess the association between different types of first-degree relatives' stroke history and the incidence risk of stroke, and to explore the familial aggregation and intergenerational transmission of stroke risk.

Methods: A prospective cohort study design was adopted, based on the data of the Fangshan Family-based Ischemic Stroke Study in China(FISSIC). The Cox proportional hazards model was used to analyze the association between different types of first-degree relatives' stroke history (paternal stroke history, maternal stroke history, parental history of stroke, and sibling stroke history) and the incidence risk of stroke. The hazard ratio (HR) and its 95% confidence interval (CI) were estimated. Stroke was classified as early-onset and late-onset, and the association between different types of first-degree relatives ' stroke history and the risk of early-onset and late-onset stroke was further analyzed.

Results: A total of 3 631 subjects were included in the study, with 1 650 males (45.4%) and a mean age of (56.7±8.4) years. The median follow-up duration was 6.98 years, during which 1 337 new cases of stroke occurred. The risk of stroke occurrence was higher in those with a first-degree relative history of stroke (HR=1.24, 95%CI: 1.08-1.43, P=0.002). For different types of first-degree relatives ' stroke history, the association between maternal and sibling history of stroke and the incidence risk of stroke was statistically significant (maternal history of stroke: HR=1.15, 95%CI: 1.00-1.32, P=0.049; sibling history of stroke: HR=1.17, 95%CI: 1.03-1.33, P=0.013). No association was observed between a paternal history of stroke or a parental history of stroke and the risk of stroke (both P>0.05). Compared with those without a family history, the HRs for early-onset and late-onset stroke in those with a maternal history of stroke were 1.40 (95%CI: 1.10-1.77, P=0.005) and 1.19 (95%CI: 1.01-1.41, P=0.043), respectively. Compared with those without a family history, the HRs for early-onset and late-onset stroke in those with a sibling history of stroke were 1.28 (95%CI: 1.02-1.61, P=0.034) and 1.17 (95%CI: 1.00-1.37, P=0.045), respectively.

Conclusion: Stroke exhibits familial aggregation, and the history of stroke in first-degree relatives is associated with the incidence risk of stroke. In particular, the maternal and sibling stroke history demonstrate a stronger association with the incidence risk of stroke. This finding suggests that during the intergenerational transmission of stroke risk, the genetics and family environment reflected by the maternal and sibling stroke history may play an important role.