Healthy lifestyles are associated with alleviating the single-nucleotide polymorphism-based genetic risks of ischaemic stroke, intracerebral haemorrhage and myocardial infarction.
Level 3 - non-randomized controlled study
Prospective cohort study analyzing observational follow-up data from a population biobank.
PubMed 38925676 · doi:10.1136/svn-2024-003257
What was done
Researchers evaluated 315,044 UK Biobank participants free of stroke and myocardial infarction (MI) at baseline over a median follow-up of 12.8 years. Disease-specific genetic risk scores (GRS) and lifestyle risk scores (LRS, based on smoking, alcohol consumption, physical activity, diet, and sleep patterns) were categorized into low, intermediate, and high tertiles. Cox proportional hazards models were used to examine associations with incident ischaemic stroke (IS, n = 4,642), intracerebral haemorrhage (ICH, n = 1,046), and MI (n = 9,485).
What was found
Compared with the low GRS/low LRS group, participants with both high GRS and high LRS had higher risks of IS (HR 3.45, 95% CI 2.71 to 4.41), ICH (HR 2.32, 95% CI 1.40 to 3.85), and MI (HR 4.89, 95% CI 4.16 to 5.75). Among participants in the high genetic risk category, a favorable lifestyle (low LRS) compared to an unfavorable lifestyle (high LRS) was associated with substantially lower standardized 14-year event rates: 1.78% (95% CI 1.63% to 1.94%) versus 4.40% (95% CI 3.45% to 5.36%) for IS; 3.34% (95% CI 3.12% to 3.56%) versus 8.60% (95% CI 7.38% to 9.81%) for MI; and 0.36% (95% CI 0.31% to 0.42%) versus 0.71% (95% CI 0.36% to 1.05%) for ICH.
Why it matters
These findings show that a favorable lifestyle is associated with mitigating high genetic susceptibility for both ischemic and hemorrhagic cardiovascular events, cutting absolute risk estimates by more than half across all three conditions.
Limits
The study is observational and cannot establish causality. Lifestyle behaviors were primarily self-reported at baseline, risking recall bias and misclassification from changes over time. UK Biobank participants also exhibit a recognized healthy volunteer bias and are predominantly of European ancestry, which may limit generalizability to other populations.
Cited by
- supports Multiple studies show that high polygenic disease risk can be neutralized by adopting healthy lifestyle factors.