The relation between questions indicating transient ischaemic attack and stroke in 20 years of follow up in men and women in the Renfrew/Paisley Study

Study objective-Transient ischaemic attack (TIA) is often a precursor to st roke, so identification of people experiencing TIA could assist in stroke p revention by indicating those at high risk of stroke who would benefit most from intervention for other stroke risk factors. The objective of this stu dy was to investigate whether answers to a simple questionnaire for TIA cou ld predict the occurrence of stroke in the following 20 years. Design-Prospective cohort study, conducted between 1972 and 1976, with 20 y ears of follow up. Setting Renfrew and Paisley, Scotland. Participants-7052 men and 8354 women aged 45-64 years at the time of screen ing completed a questionnaire and attended a physical examination. The ques tionnaire asked participants if they had ever, without warning, suddenly lo st the power of an arm, suddenly lost the power of a leg, suddenly been una ble to speak properly or suddenly lost consciousness. These four questions were taken as indicators of TIA and were related to subsequent stroke morta lity or hospital admission. Main results-For women, each question was significantly related to stroke r isk, whereas for men only the question on loss of power of arm was signific antly related to stroke risk. Men and women answering two or more questions positively had double the relative rate of stroke compared with men and wo men answering none of the questions positively, even after adjusting for ot her risk factors for stroke. Conclusions-A simple questionnaire for TIA could help predict stroke over 2 0 years of follow up. Targeting men and women who report TIA with early tre atment could help to prevent strokes from occurring.