Cardiovascular Diseases Clinical Trial
To investigate stroke risk using the National Academy of Sciences Twin Registry.
BACKGROUND:
The epidemiology and common risk factors for cerebrovascular disease have been well
documented by cross-sectional and longitudinal population surveys. These studies have
generally involved unrelated individuals with little information on family history. Despite
a significant role in cardiovascular risk, few studies have investigated familial
contributions to stroke risk, and its importance was unknown. Recognition of the importance
of hereditary influences on vascular disease of the heart has contributed, in large part, to
the current emphasis on the molecular biology of vascular disease and a more balanced view
that recognized both genetic and environmental influences on coronary artery disease. Twin
studies represented a simple and uniquely powerful tool for analyzing genetic and
environmental contributions to complex human phenotypes. Studies of cardiovascular risk have
shown the importance of heritable factors, and it was hypothesized that similar genetic
factors played a role in development of stroke.
With improved understanding of stroke risk factors (both genetic and environmental), early
prevention measures can begin in high risk groups as early as childhood, an approach already
applied to cardiovascular disease. Demonstration of a significant heritable risk for stroke
should also prompt and help direct, further investigation into the molecular mechanisms of
the genetic influences on stroke and may identify new approaches for stroke prevention and
treatment, as it has for cardiovascular disease.
DESIGN NARRATIVE:
The twins have been surveyed periodically over the past two decades, most recently in 1985.
Information obtained included questions on vascular risk factors, myocardial disease, and
stroke. An analysis was made on an estimation of heritable risk. A comparison was made
between monozygotic (MZ) and dizygotic (DZ) twins. If genes influenced the prevalence of
stroke, there should have been more MZ twin pairs with stroke. Measures of concordance and
heritability were used to estimate the size of the genetic contribution. Secondary analyses
focussed on compound risk factors (e.g. hypertension and diabetes), less well documented
risk factors (e.g. diet and personality), and the heritability of individual stroke risk
factors.
The study completion date listed in this record was obtained from the "End Date" entered in
the Protocol Registration and Results System (PRS) record.
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