Vascular Disease of the Brain—Epidemiologic Aspects: The Framingham Study

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Abstract
Factors associated with risk of developing a thrombotic infarction of the brain ("cerebral thrombosis") and myocardial infarction in 12 years in approximately 5000 a-dult men and women initially free of both diseases was determined by prospective longitudinal study. In general, factors which predispose to myocardial infarction also increased susceptibility to brain infarction. Subjects most highly susceptible to development of a "stroke" tended to be aged, ill with cardiovascular disease, with an enlarged heart, a low vital capacity, hypertension and ECG abnormalities. "Elevated" serum cholesterol levels were associated with excess risk of both myocardial infarction and brain infarction in men and younger women. Persons predisposed to atherosclerosis by elevation of the blood pressure and serum cholesterol level who in addition had ECG abnormalities were extremely susceptible to both myocardial infarction and "stroke". The obese exhibited no excess risk of either myocardial or brain infarction. In women the incidence of thrombotic brain infarction and myocardial infarction was almost identical. In men incidence of brain infarction lagged 20 years behind myocardial infarction. A marked male predominance was noted in myocardial, but not brain infarction.