Higher cardiovascular health to indicate increased genetic risk for stroke

Genes and lifestyle factors together play a role in stroke risk. However, even for people at high risk for stroke, adopting a healthy cardiovascular lifestyle may significantly lower the risk of stroke in their lifetime, according to new research published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.

For the study, researchers reviewed data from the Atherosclerosis Risk in Communities (ARIC) Study, a community-based study of more than 11,500 white and Black adults over the age of 45, who had no history of stroke at enrollment. Study participants were followed for 28 years; 45% were men, and 55% were women.

Researchers estimated the lifetime risk of a first stroke according to levels of genetic risk based on a stroke polygenic risk score. Polygenic risk scores were derived from over 3 million genetic variants, or single-nucleotide polymorphisms, across the whole genome.

The number of single-nucleotide polymorphisms related to stroke was standardized at more than 2.7 million for white adults and more than 2.2 million single-nucleotide polymorphisms for Black adults. The researchers investigated the potential impact of the American Heart Association's Life's Simple 7 recommendations and whether higher Life's Simple 7 cardiovascular score (equating to better cardiovascular health) lessened the negative impact of a high genetic risk on the lifetime risk of stroke.

Researchers found that at age 45, study participants with the lowest polygenic risk scores had the lowest lifetime risk of stroke, 9.6%. The lifetime risk of stroke was 13.8% for participants with an intermediate polygenic risk score and 23.2% for participants with a high polygenic risk score.

Those with both high genetic risk for stroke and low cardiovascular health had the highest lifetime risk of stroke score of 24.8%. Participants who had a high polygenic risk and optimal cardiovascular health were observed to mitigate their lifetime risk of stroke by up to 43%, compared to those with inadequate cardiovascular health. This translated into to about six additional years without a stroke.

Researchers ended that this was the first step in using genetic information to identify people who may be at higher risk for stroke, and also in motivating people to make lifestyle changes for cardiovascular disease prevention. This type of study shows us the possibilities for the future.

Reference: "Higher cardiovascular health may partially offset increased genetic risk for stroke"; Journal of the  American Heart Association, DOI:10.1161/JAHA.122.025703