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June 02, 2015; 84 (22) Article

Primary prevention of stroke by a healthy lifestyle in a high-risk group

Susanna C. Larsson, Agneta Åkesson, Alicja Wolk
First published May 1, 2015, DOI: https://doi.org/10.1212/WNL.0000000000001637
Susanna C. Larsson
From the Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Agneta Åkesson
From the Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Alicja Wolk
From the Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Primary prevention of stroke by a healthy lifestyle in a high-risk group
Susanna C. Larsson, Agneta Åkesson, Alicja Wolk
Neurology Jun 2015, 84 (22) 2224-2228; DOI: 10.1212/WNL.0000000000001637

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Abstract

Objective: To examine the impact of a healthy lifestyle on stroke risk in men at higher risk of stroke because of other cardiovascular diseases or conditions.

Methods: Our study population comprised 11,450 men in the Cohort of Swedish Men who had a history of hypertension, high cholesterol levels, diabetes, heart failure, or atrial fibrillation. Participants had completed a questionnaire about diet and lifestyle and were free from stroke and ischemic heart disease at baseline (January 1, 1998). We defined a healthy lifestyle as a low-risk diet (≥5 servings/d of fruits and vegetables and <30 g/d of processed meat), not smoking, ≥150 min/wk of physical activity, body mass index of 18.5 to 25 kg/m2, and low to moderate alcohol consumption (>0 to ≤30 g/d). Ascertainment of stroke cases was accomplished through linkage with the National Inpatient Register and the Swedish Cause of Death Register.

Results: During a mean follow-up of 9.8 years, we ascertained 1,062 incident stroke cases. The risk of total stroke and stroke types decreased with increasing number of healthy lifestyle factors. The multivariable relative risk of total stroke for men who achieved all 5 healthy lifestyle factors compared with men who achieved 0 or 1 factor was 0.28 (95% confidence interval 0.14–0.55). The corresponding relative risks (95% confidence interval) were 0.31 (0.15–0.66) for ischemic stroke and 0.32 (0.04–2.51) for hemorrhagic stroke.

Conclusions: A healthy lifestyle is associated with a substantially reduced risk of stroke in men at higher risk of stroke.

GLOSSARY

BMI=
body mass index;
CI=
confidence interval;
FFQ=
food-frequency questionnaire;
ICD-10=
International Classification of Diseases, Tenth Revision

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at Neurology.org

  • Received October 8, 2014.
  • Accepted in final form February 20, 2015.
  • © 2015 American Academy of Neurology
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