Healthy lifestyle may cut stroke risk

Women who engage in a low-risk lifestyle with a healthy diet may be at significantly reduced risk of stroke, according to a new study in Neurology.

Researchers at the Karolinska Institute in Stockholm, Sweden, used data from 31,696 women in the population-based Swedish Mammography Cohort. At baseline, the participants had no cardiovascular disease or cancer and completed a questionnaire regarding diet and lifestyle. A low-risk lifestyle was defined as having a healthy diet, which was considered top 50% of Recommended Food score; no history of smoking; a body mass index below 25; being physically active (considered to be walking/bicycling ≥ 40 min/d and exercising ≥ 1 h/wk); and consuming a moderate amount of alcohol (5 to 15 g/d). The Swedish National Patient Register and the Swedish Cause of Death Register were used to identify stroke cases.

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In the cohort during the 10.4 years of follow-up, there were 1554 incident stroke cases, which included 1155 cerebral infarctions, 246 hemorrhagic strokes, and 153 unspecified strokes. Stroke risk, particularly the risk of cerebral infarction, decreased steadily as the number of low-risk lifestyle factors increased. The multivariable relative risks (95% confidence interval) of cerebral infarction across an increasing number of low-risk factors (1 to 5) were .72 (0.56–0.93), 0.67 (0.52–0.85), 0.57 (0.44–0.74), 0.54 (0.40–0.73), and 0.38 (0.20–0.73) compared with no low-risk factors.

Researchers believe that their study has several strengths including the large number of stroke cases, information on potential confounders, the nearly complete follow-up allowed by linkage with Swedish registries, and the prospective, population-based design. “Because this study is population-based and well represented the source population,” the authors said, “the results should be generalizable to all women.” They cautioned, however, that given the observational design, residual confounding cannot be excluded.

The investigators concluded that adopting low-risk lifestyle factors can substantially reduce the risk of strokes. A healthy diet and combined with a low-risk lifestyle appears to substantially reduce the risk of cerebral infarctions.

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