BACKGROUND: The joint effects of different lifestyle factors on stroke risk are still to some extent unclear, especially regarding hemorrhagic stroke. METHODS: We prospectively investigated the association of different indicators of lifestyle (smoking, body mass index, physical activity, and vegetable and alcohol consumption) with total and type-specific stroke incidence among 36 686 Finnish participants who were 25 to 74 years old and free of coronary heart disease and stroke at baseline. RESULTS: During a mean follow-up period of 13.7 years, 1478 people developed an incident stroke event (1167 ischemic and 311 hemorrhagic). The multivariate-adjusted (age, sex, education, family history of stroke, history of diabetes mellitus, systolic blood pressure, and serum total cholesterol level) hazard ratios associated with adherence to 0 to 1 (reference group), 2, 3, 4, and 5 healthy lifestyle indicators were 1, 0.66, 0.57, 0.51, and 0.33 (P < .001 for trend) for total stroke; 1, 0.67, 0.60, 0.50, and 0.30 (P < .001 for trend) for ischemic stroke; and 1, 0.63, 0.49, 0.49, and 0.40 (P < .001 for trend) for hemorrhagic stroke, respectively. These inverse associations were similar in both men and women. The partial population attributable risk percentages associated with adherence to 3, 4, and 5 healthy lifestyle indicators were 26.3%, 43.8%, and 54.6% for total stroke; 22.7%, 45.3%, and 59.7% for ischemic stroke; and 35.0%, 35.0%, and 36.1% for hemorrhagic stroke, respectively. CONCLUSION: Healthy lifestyle factors are associated with a lower risk of stroke, and there is a graded inverse association between the number of healthy lifestyle indicators and the risks of total, ischemic, and hemorrhagic stroke.
BACKGROUND: The joint effects of different lifestyle factors on stroke risk are still to some extent unclear, especially regarding hemorrhagic stroke. METHODS: We prospectively investigated the association of different indicators of lifestyle (smoking, body mass index, physical activity, and vegetable and alcohol consumption) with total and type-specific stroke incidence among 36 686 Finnish participants who were 25 to 74 years old and free of coronary heart disease and stroke at baseline. RESULTS: During a mean follow-up period of 13.7 years, 1478 people developed an incident stroke event (1167 ischemic and 311 hemorrhagic). The multivariate-adjusted (age, sex, education, family history of stroke, history of diabetes mellitus, systolic blood pressure, and serum total cholesterol level) hazard ratios associated with adherence to 0 to 1 (reference group), 2, 3, 4, and 5 healthy lifestyle indicators were 1, 0.66, 0.57, 0.51, and 0.33 (P < .001 for trend) for total stroke; 1, 0.67, 0.60, 0.50, and 0.30 (P < .001 for trend) for ischemic stroke; and 1, 0.63, 0.49, 0.49, and 0.40 (P < .001 for trend) for hemorrhagic stroke, respectively. These inverse associations were similar in both men and women. The partial population attributable risk percentages associated with adherence to 3, 4, and 5 healthy lifestyle indicators were 26.3%, 43.8%, and 54.6% for total stroke; 22.7%, 45.3%, and 59.7% for ischemic stroke; and 35.0%, 35.0%, and 36.1% for hemorrhagic stroke, respectively. CONCLUSION: Healthy lifestyle factors are associated with a lower risk of stroke, and there is a graded inverse association between the number of healthy lifestyle indicators and the risks of total, ischemic, and hemorrhagic stroke.
Authors: Yun Shen; Lizheng Shi; Elizabeth Nauman; Peter T Katzmarzyk; Eboni G Price-Haywood; Alessandra N Bazzano; Somesh Nigam; Gang Hu Journal: Stroke Date: 2019-02 Impact factor: 7.914
Authors: Katriina Heikkilä; Eleonor I Fransson; Solja T Nyberg; Marie Zins; Hugo Westerlund; Peter Westerholm; Marianna Virtanen; Jussi Vahtera; Sakari Suominen; Andrew Steptoe; Paula Salo; Jaana Pentti; Tuula Oksanen; Maria Nordin; Michael G Marmot; Thorsten Lunau; Karl-Heinz Ladwig; Markku Koskenvuo; Anders Knutsson; France Kittel; Karl-Heinz Jöckel; Marcel Goldberg; Raimund Erbel; Nico Dragano; Dirk DeBacquer; Els Clays; Annalisa Casini; Lars Alfredsson; Jane E Ferrie; Archana Singh-Manoux; G David Batty; Mika Kivimäki Journal: Am J Public Health Date: 2013-05-16 Impact factor: 9.308
Authors: Anne M Vangen-Lønne; Peter Ueda; Pablo Gulayin; Tom Wilsgaard; Ellisiv B Mathiesen; Goodarz Danaei Journal: Eur J Epidemiol Date: 2018-01-02 Impact factor: 8.082
Authors: Wenhui Zhao; Peter T Katzmarzyk; Ronald Horswell; Yujie Wang; Jolene Johnson; William T Cefalu; Donna H Ryan; Gang Hu Journal: J Clin Endocrinol Metab Date: 2013-05-28 Impact factor: 5.958
Authors: Wenhui Zhao; Peter T Katzmarzyk; Ronald Horswell; Yujie Wang; Jolene Johnson; Gang Hu Journal: Diabetologia Date: 2014-02-28 Impact factor: 10.122
Authors: Heinrich P Mattle; Michael Brainin; Angel Chamorro; Hans Christoph Diener; Werner Hacke; Didier Leys; Bo Norrving; Nick Ward Journal: Stroke Date: 2012-07-26 Impact factor: 7.914