- Researchers investigated how cardiovascular health interacts with a high genetic risk for stroke.
- They found that optimal cardiovascular health reduces the lifetime risk of stroke in those at high genetic risk.
- Basic lifestyle interventions, such as following a healthy diet, exercising and not smoking, partially offset this risk.
Stroke is the second leading cause of death worldwide and a leading cause of disability and dementia. In the United States, adults age 25 and older have a lifetime risk of stroke of about 24%.
Both genetic and environmental factors influence stroke risk. Management of cardiometabolic risk factors and promotion of healthy lifestyle behavior are
Recent genome-wide association
It has been unclear whether improved cardiovascular health can offset genetic risk for stroke.
Recently, however, researchers have found that maintaining optimal cardiovascular health can partially offset a high genetic risk for stroke, reducing a person’s overall lifetime risk of stroke.
The study appears in
“The public message is clear,” said Dr. Tatjana Rundek, a professor of neurology and public health sciences at the University of Miami, not involved in the study. Medical News Today.
“Regardless of the potential of carrying ‘bad’ genetic risk, improving cardiovascular health should be the most important public health priority. Promoting ideal cardiovascular health should start at an early age, and many of us believe that we should start with a healthy diet and exercise at birth,” she noted.
For the study, researchers analyzed data from 11,568 middle-aged adults who were stroke-free at baseline, and followed them for an average of 28 years.
Their lifetime risk for stroke was estimated from genetic risk levels based on a validated polygenic stroke risk score and cardiovascular health levels according to the American Heart Association.
The initial “Life’s Simple 7” recommendations are:
- cholesterol control
- blood pressure control
- blood glucose control
- Physical activity
- healthy diet
- no smoking
- while maintaining a healthy body mass index (BMI).
Participants were assessed for Life’s Simple 7 at the start of the study by a mix of self-reported and clinically assessed measures.
During the follow-up period, 1,138 participants were diagnosed with stroke. Of these, 14% had a low genetic risk, 41.7% had an intermediate genetic risk and 44.3% a high genetic risk.
The researchers further noted that participants who scored low on Life’s Simple 7 experienced 56.8% of stroke events, while those with optimal Life’s Simple 7 measures experienced 6.2% of strokes.
Together, they found that participants with the highest genetic risk and the lowest Life’s Simple 7 scores had the highest lifetime risk of stroke by 24.8%.
Further, they found that across all polygenic risk score categories, those with an optimal Life’s Simple 7 score had a 30-43% lower lifetime risk of stroke than those with an inadequate score. Life’s Simple 7″.
This, they noted, corresponded to 6 more years of stroke-free life in those with the highest genetic risk.
Prof. Lu Qi, chair and distinguished professor in the Department of Epidemiology at Tulane University School of Public Health and Tropical Medicine, who was not involved in the study, said MNT:
“”Life is Simple 7″ [has] has been linked to lower genetic risks of cardiovascular disease, including stroke in previous studies. Not surprisingly, an optimal ‘Life’s Simple 7’ score is associated with a lower genetic variation in stroke risk.”
When asked how Life’s Simple 7 can reduce genetic risk of stroke.
Prof. Rundek said that “[t]The precise mechanism by which combined risk/lifestyle factors and genetic factors influence stroke risk is unknown and likely to be complex.”
“One way to explain how ideal cardiovascular health – ‘Life’s Simple 7’ – can reduce genetic risk of stroke is to think about genetic susceptibility to stroke risk in the presence of harmful ‘Life’s Simple 7’ factors, because certain genes can only be expressed when activated by the presence of environmental factors or weak Life’s Simple 7 [scores for] cardiovascular health”, she pointed out.
“If we reduce these environmental factors and achieve ideal cardiovascular health ‘Life’s Simple 7’ [score] – The stroke risk genes that we potentially carry – would not be expressed to harm and contribute to the increased risk of stroke,” added Prof. Rundek.
The researchers concluded that maintaining optimal cardiovascular health may partially offset a high genetic risk for stroke.
When asked about the limitations of the study, Prof. Qi noted that since the study was observational in nature, it was “limited to causal inference.”
Prof. Christie M. Ballantyne, chief of cardiology at Baylor University, also not involved in the study, added that:
“The data for African Americans was not strong, and other racial and ethnic groups, such as Hispanics, Asians, and East Asians, were not well represented in this study. Additional studies in other populations are needed to optimize polygenic risk scores to be more useful in clinical practice for all our patients.
Prof. Rundek added that “[i]It can be difficult to achieve and maintain ideal cardiovascular ‘Life’s Simple 7’ [score] if there is a strong individual genetic susceptibility to the risk of stroke [which includes] an increased risk of hypertension and other ‘Life’s Simple 7’ factors.”
“Furthermore, there are some genetic markers—rare alleles—that are not included in polygenic risk scores as they contribute to risk only in a small amount. However, they can have a cumulative effect if they are present within an individual. […] How changes in Life’s Simple 7 factors over time affect genetic risk is also an interesting question. All of these will need to be carefully investigated in future studies,” she explained.