A healthy lifestyle can offset a high genetic risk of stroke

According to a new study conducted by UTHealth Houston, published today in the Journal of the American Heart Association.

The study included 11,568 adults aged 45 to 64 who had not had a stroke at baseline and were followed for a median of 28 years. Cardiovascular health scores were based on the American Heart Association’s Life’s Simple 7 recommendations, which include quitting smoking, better diet, physical activity, weight loss, blood pressure management, control cholesterol and lowering blood sugar. The lifetime risk of stroke was calculated using what is called a polygenic stroke risk score, with people who had more genetic risk factors linked to stroke risk getting a higher score.

“Our study confirmed that modifying lifestyle risk factors, such as blood pressure control, can offset a genetic risk for stroke,” said Myriam Fornage, PhD, lead author and professor. of Molecular Medicine and Human Genetics at the Institute for Molecular Medicine at UTHealth Houston. . “We can use genetic information to determine who is most at risk and encourage them to adopt a healthy cardiovascular lifestyle, such as following the AHA’s Life’s Simple 7, to reduce that risk and live a longer, healthier life. better health.” Fornage is the Laurence and Johanna Favrot Professor Emeritus of Cardiology at McGovern Medical School at UTHealth Houston.

Each year, 795,000 people in the United States suffer a stroke, according to the Centers for Disease Control and Prevention. This equates to someone having a stroke every 40 seconds and someone dying from a stroke every 3.5 minutes. Stroke is a leading cause of severe long-term disability, with stroke reducing mobility in more than half of stroke survivors aged 65 and over. But stroke also occurs in young adults – in 2014, 38% of people hospitalized for stroke were under the age of 65.

The people in the study who scored the highest for stroke genetic risk and the poorest for cardiovascular health had the highest lifetime risk of having a stroke at 25%. Regardless of the level of genetic risk for stroke, those who had practiced optimal cardiovascular health reduced that risk by 30% to 45%. This added nearly six more years of stroke-free life.

Overall, people with low adherence to Life’s Simple 7 had the most stroke events (56.8%) while those with high adherence had 71 strokes (6.2%).

A limitation of the article is that the polygenic risk score has not been widely validated, so its clinical utility is not optimal, especially for people of diverse racial or ethnic backgrounds.

Co-authors from UTHealth Houston were Nitesh Enduru, MPH; a graduate research assistant at UTHealth Houston School of Biomedical Informatics; and Eric Boerwinkle, PhD, dean of the UTHealth School of Public Health. Other contributors were Adrienne Tin, PhD; Michael E. Griswold, Ph.D.; and Thomas H. Mosley, PhD, of the University of Mississippi in Jackson, Mississippi; and Rebecca F. Gottesman, MD, PhD, of the National Institute of Neurological Disorders and Stroke (NINDS). The first author of the article was Emy A. Thomas, formerly of UTHealth Houston.

Fornage and Boerwinkle are also members of the University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences.

The study was funded by NINDS (including grants U19-NS120384 and UH3-NS100605), part of the National Institutes of Health.

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