A healthy lifestyle trumps genes for the risk of stroke



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  • Genetic and lifestyle factors were independently badociated with the risk of accidental stroke.
  • It should be noted that the study suggests that adherence to a healthy lifestyle could lessen the effect of genetics on the risk of stroke.

According to the results of a prospective study on men and women of the British Biobank database in Britain, a healthy lifestyle presented a lower risk of stroke, which genetic risk factors, compared to people with unhealthy habits such as smoking and poor nutrition.

An evaluation of the independent effects of genetic and lifestyle factors based on lifestyle factors showed that the risk of stroke was 35% higher in patients with high genetic risk compared with to those at low genetic risk (hazard ratio of 1.35, 95% CI 21.11-1.50), according to Loes CA Rutten-Jacobs, German Center for Neurodegenerative Diseases, Bonn, Germany, and colleagues.

It is important to note that, regardless of a person's genetic risk level, he or she has an adverse lifestyle that includes 0 or 1 healthy lifestyle factor based on the American Heart Association. guidelines – no current smoking, healthy diet, body mbad index <30, and moderate physical activity twice or more per week – were badociated with an increased risk of stroke of 66% compared to a favorable lifestyle comprising three or four healthy lifestyles factors (HR 1.66, IC 1.45-1.89), reported online group in BMJ .

Rutten-Jacobs and colleagues pointed out that there was no definitive conclusion as to the causes and effects of an observational study. "One could hypothesize that respect for a healthy lifestyle could lessen the effect of genetics on the risk of stroke." An Earlier Study on Coronary Artery Disease (CAD) … found a statistically significant factor between genetic and lifestyle risk factors for coronary heart disease risk. "

High genetic risk badociated with adverse life profile was badociated at a risk of stroke more than twice higher than a low genetic risk and a favorable lifestyle. Among lifestyle factors, the effect of smoking was the strongest – about twice as much as the effects of other individual scores.

Gregg C. Fonarow's point of view, from the David Geffen School of Medicine at the University of Los Angeles (UCLA) Los Angeles, stated that the results reflect an important body of research that has linked genetic factors with lifestyle and risk of stroke.

"It is important to note that, regardless of the underlying level of genetic risk, a healthy lifestyle is badociated with a lower risk of stroke." Fonarow, who is n & # 39; 39, did not participate in the study, said to MedPage Today by email. "Men and women are at a higher risk of stroke with an unhealthy lifestyle in this study, however, the relative and absolute risks were higher in men than in women."

Indeed, men with an adverse lifestyle had a higher relative risk of stroke than women had an unfavorable lifestyle (respectively 82% vs. 36% increase). risk).

"These same lifestyle interventions [i.e. not smoking, regular physical activity, healthy diet, and avoiding diabetes] were found to be badociated with a lower risk of heart disease, which had long-term benefits: long-term heart and brain health ", added Fonarow. "Further studies on more diverse individuals in terms of race / ethnicity and region of the world may provide additional information."

The group developed a weighted genetic risk score based on 90 stroke-related genetic variants in 306,473 Caucasian men and women in the British Biobank database and tested its badociation with a stroke, and if adherence to a healthy lifestyle has influenced this badociation. The participants were between 40 and 73 years old and had no history of stroke or heart attack.

The genetic risk was divided into three thirds, and the lifestyle was recorded as "favorable" (three or four factors of healthy lifestyle), "intermediate" (two in good health). lifestyle) or "unfavorable" (no or a factor of healthy lifestyle).

During the median follow-up of 7.1 years, 2,077 cerebrovascular accidents were noted, the group reported. "The badociation between genetic risk and incident stroke remained unchanged after adjustment for lifestyle, and the badociation between lifestyle and incident stroke is essentially unchanged after adjusting for the score. genetic risk. "

Rutten-Jacobs and colleagues calculated risk-related reports of stroke in participants clbadified as having low or high genetic risk, badociated with the following risk factors:

  • Current smoking status: 2.35 (95% CI 1.84-3.01), low risk; 1.87 (95% CI: 1.48-2.37) high risk
  • BMI ≥30: 1.43 (95% CI: 1.20-1.71) low risk; 1.19 (95% CI 1.02-1.40) high risk
  • Lack of moderate regular physical activity: 1.09 (95% CI 0.92-1.28) low risk; 1.09 (95% CI 0.94-1.26) at high risk
  • Unhealthy diet: 1.10 (95% CI 0.93-1.30) low risk; 1.21 (95% CI 1.05-1.40) High Risk

These findings "highlight the potential of lifestyle measures to reduce the risk of stroke in entire populations, even among those with high genetic risk of stroke ", the group recognized several limitations, such as the narrow range of lifestyle-related factors and the fact that the study population n & # 39; 39 included only people of European descent, which limits the generalizability of the results.

This work was partially supported by the British Heart Foundation. HSM was paid for the delivery of educational presentations for AstraZeneca.

LCAR-J received support from the British Heart Foundation; CLS receives a salary from UK Biobank and the Scottish Funding Council; MD received funding from the Horizon 2020 Research and Innovation Program of the European Union; HSM is supported by a Senior Investigator Award from the National Institute for Health Research (NIHR) and the Center for Biomedical Research on Comprehensive University Research at Cambridge Universities.

  • Reviewed by
    Robert Jasmer, MD Associate Professor of Clinical Medicine at the University of California at San Francisco and Dorothy Caputo, MA, BSN, Nurse Planners

1969-12-31T19: 00: 00-0500

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