 |
|
Healthy Lifestyle and the Risk of Stroke in Women
Tobias Kurth, MD, ScD;
Steven C. Moore, MPH;
J. Michael Gaziano, MD, MPH;
Carlos S. Kase, MD;
Meir J. Stampfer, MD, DrPH;
Klaus Berger, MD, MPH, MSc;
Julie E. Buring, ScD
Arch Intern Med. 2006;166:1403-1409.
Background Healthy lifestyle has been associated with decreased risk of coronary heart disease. In contrast, little is known about its association with stroke risk.
Methods This is a prospective cohort study among 37 636 women 45 years or older participating in the Women's Health Study. Stroke was self-reported and confirmed by means of medical record review. We considered the following self-reported lifestyle factors: smoking, alcohol consumption, exercise, body mass index, and diet. The health index was calculated from these variables by assigning scores from 0 to 4 to the respective variable categories, with a higher score indicating healthier behavior. Healthy behavior was defined as never smoking, alcohol consumption between 4 and 10.5 drinks per week, exercise 4 or more times per week, body mass index (calculated as weight in kilograms divided by the square of height in meters) less than 22, and a diet high in cereal fiber, folate, and omega-3 fatty acids, with a high ratio of polyunsaturated to saturated fat, and low in trans fat and glycemic load.
Results During 10 years of follow-up, 450 strokes (356 ischemic, 90 hemorrhagic, and 4 undefined) were confirmed. Compared with participants with 0 to 4 health index points (4.3%), women with 17 to 20 health index points (4.7%) had multivariable-adjusted hazard ratios (95% confidence interval) of 0.45 (0.24-0.83; P<.001 for trend) for total stroke, 0.29 (0.14-0.63; P<.001 for trend) for ischemic stroke, and 1.27 (0.37-4.29; P = .62 for trend) for hemorrhagic stroke.
Conclusions In this large prospective cohort of apparently healthy women, a healthy lifestyle consisting of abstinence from smoking, low body mass index, moderate alcohol consumption, regular exercise, and healthy diet was associated with a significantly reduced risk of total and ischemic stroke but not of hemorrhagic stroke. Our findings underscore the importance of healthy behaviors in the prevention of stroke.
Author Affiliations: Divisions of Preventive Medicine (Drs Kurth, Gaziano, and Buring) and Aging (Drs Kurth, Gaziano, and Buring), Channing Laboratories (Dr Stampfer), Department of Medicine, Brigham and Women's Hospital, Harvard Medical School; Department of Epidemiology, Harvard School of Public Health (Drs Kurth, Stampfer, and Buring); Department of Ambulatory Care and Prevention, Harvard Medical School (Dr Buring); Massachusetts Veterans Epidemiology Research and Information Center, Boston Veterans Affairs Healthcare System (Dr Gaziano); Department of Neurology, Boston University School of Medicine (Dr Kase), Boston, Mass; Department of Epidemiology, Yale School of Public Health, New Haven, Conn (Mr Moore); and Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany (Dr Berger).
 CiteULike  Connotea  Delicious  Digg  Facebook  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Impact of a healthy lifestyle on all-cause and cardiovascular mortality after stroke in the USA
Towfighi et al.
J. Neurol. Neurosurg. Psychiatry 2012;83:146-151.
ABSTRACT
| FULL TEXT
Lifestyle Factors on the Risks of Ischemic and Hemorrhagic Stroke
Zhang et al.
Arch Intern Med 2011;171:1811-1818.
ABSTRACT
| FULL TEXT
An Apple a Day Keeps Stroke Away?: Consumption of White Fruits and Vegetables Is Associated With Lower Risk of Stroke
Wersching
Stroke 2011;42:3001-3002.
FULL TEXT
Healthy Lifestyle on the Risk of Breast Cancer
Sanchez-Zamorano et al.
Cancer Epidemiol. Biomarkers Prev. 2011;20:912-922.
ABSTRACT
| FULL TEXT
Primary prevention of stroke: blood pressure, lipids, and heart failure
Endres et al.
Eur Heart J 2011;32:545-552.
ABSTRACT
| FULL TEXT
Low Prevalence of "Ideal Cardiovascular Health" in a Community-Based Population: The Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) Study
Bambs et al.
Circulation 2011;123:850-857.
ABSTRACT
| FULL TEXT
Guidelines for the Primary Prevention of Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
Goldstein et al.
Stroke 2011;42:517-584.
ABSTRACT
| FULL TEXT
Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
Furie et al.
Stroke 2011;42:227-276.
ABSTRACT
| FULL TEXT
Effects of vitamin E on stroke subtypes: meta-analysis of randomised controlled trials
Schurks et al.
BMJ 2010;341:c5702-c5702.
ABSTRACT
| FULL TEXT
Migraine and risk of haemorrhagic stroke in women: prospective cohort study
Kurth et al.
BMJ 2010;341:c3659-c3659.
ABSTRACT
| FULL TEXT
Influence of Individual and Combined Health Behaviors on Total and Cause-Specific Mortality in Men and Women: The United Kingdom Health and Lifestyle Survey
Kvaavik et al.
Arch Intern Med 2010;170:711-718.
ABSTRACT
| FULL TEXT
Heart Disease and Stroke Statistics--2010 Update: A Report From the American Heart Association
WRITING GROUP MEMBERS et al.
Circulation 2010;121:e46-e215.
FULL TEXT
Alcohol Consumption and Functional Outcome After Stroke in Men
Rist et al.
Stroke 2010;41:141-146.
ABSTRACT
| FULL TEXT
Body Mass Index and Stroke Mortality by Smoking and Age at Menopause Among Korean Postmenopausal Women
Yi et al.
Stroke 2009;40:3428-3435.
ABSTRACT
| FULL TEXT
Trends in the Prevalence of Low Risk Factor Burden for Cardiovascular Disease Among United States Adults
Ford et al.
Circulation 2009;120:1181-1188.
ABSTRACT
| FULL TEXT
Health Behaviors From Early to Late Midlife as Predictors of Cognitive Function: The Whitehall II Study
Sabia et al.
Am J Epidemiol 2009;170:428-437.
ABSTRACT
| FULL TEXT
Healthy Living Is the Best Revenge: Findings From the European Prospective Investigation Into Cancer and Nutrition-Potsdam Study
Ford et al.
Arch Intern Med 2009;169:1355-1362.
ABSTRACT
| FULL TEXT
Methodological considerations and differences according to sex and stroke subtypes
Kurth
BMJ 2009;338:b1305-b1305.
FULL TEXT
Risk of stroke and lifestyle
Giles
BMJ 2009;338:b14-b14.
FULL TEXT
Heart Disease and Stroke Statistics--2009 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee
WRITING GROUP MEMBERS et al.
Circulation 2009;119:e21-e181.
FULL TEXT
Primary Prevention of Stroke: Impact of Healthy Lifestyle
Gorelick
Circulation 2008;118:904-906.
FULL TEXT
Primary Prevention of Stroke by Healthy Lifestyle
Chiuve et al.
Circulation 2008;118:947-954.
ABSTRACT
| FULL TEXT
Heart Disease and Stroke Statistics--2008 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee
Writing Group Members et al.
Circulation 2008;117:e25-e146.
FULL TEXT
Prospective study of dietary pattern and risk of Parkinson disease
Gao et al.
Am J Clin Nutr 2007;86:1486-1494.
ABSTRACT
| FULL TEXT
Clustering of Multiple Healthy Lifestyle Habits and Health-Related Quality of Life Among U.S. Adults With Diabetes
Li et al.
Diabetes Care 2007;30:1770-1776.
ABSTRACT
| FULL TEXT
Lipid levels and the risk of ischemic stroke in women
Kurth et al.
Neurology 2007;68:556-562.
ABSTRACT
| FULL TEXT
Heart Disease and Stroke Statistics--2007 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee
Rosamond et al.
Circulation 2007;115:e69-e171.
FULL TEXT
The Socioeconomic Gradient in the Incidence of Stroke: A Prospective Study in Middle-Aged Women in Sweden
Kuper et al.
Stroke 2007;38:27-33.
ABSTRACT
| FULL TEXT
|
