Unhealthy Lifestyle More Than Doubles Stroke Risk
who lead unhealthy lifestyles are more than twice as likely to suffer a
stroke than thosewho eat and drink sensibly, don't smoke, and take
regular exercise, finds a study published on the British Medical
is one of the leading causes of illness and death worldwide. There is
good evidence to suggest that lifestyle behaviors like smoking,
physical activity and diet can influence the risk of heart disease, but
their impact on stroke is less well known.
researchers set out to examine the impact of four health behaviors on
stroke risk in a large group of men and women living in Norfolk,
study involved 20,040 men and women aged 40-79 years old who were
taking part in the European Prospective Investigation into Cancer Study
(EPIC). Between 1993 and 1997, participants completed a detailed health
and lifestyle questionnaire and underwent a thorough health examination
by trained nurses.
scored one point for each of four healthy behaviors: current
non-smoking, physically not inactive, moderate alcohol intake (1-14
units per week) and blood vitamin C levels of 50 µmol/l or
more, indicating fruit and vegetable intake of at least five servings a
individual could therefore have a total health behavior score ranging
from zero to four, with a higher score indicating more protective
were then followed for an average of 11 and a half years. Strokes were
recorded using death certificates and hospital discharge data.
were a total of 599 incident strokes during the follow-up period. After
adjusting for other factors that may have affected the results, the
risk of stroke was 2.3 times greater in those with a score of zero
compared to those with a score of four.
significantly higher percentage of women scored four compared to men.
risk of stroke increased in linear fashion with every point decrease in
health behavior score. So, for example, those with a score of two were
one and a half (1.58) times more likely to have a stroke than those
with a score of four, while those with a score of just one were just
over twice (2.18) as likely to have a stroke.
authors acknowledge that their study has some limitations, but suggest
that the results may provide further incentive and support for the
notion that small differences in lifestyle may have substantial
potential impact on stroke risk.
conclusion that lifestyle predicts the risk of stroke should help to
inform individuals' choices and policy-makers' decisions, writes Dr.
Matthew Giles from the Stroke Prevention Research Unit at John
Radcliffe Hospital Oxford in an accompanying editorial.
less encouraging is the small proportion of participants with a
lifestyle that protectsagainst stroke – although lifestyle
interventions could be of great benefit, a huge shift in behavior will
be needed to achieve this, he concludes.
more information on the BMJ-British Medical Journal, visit www.bma.org.