Larsson Susanna C, Åkesson Agneta, Wolk Alicja
From the Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Neurology. 2015 Jun 2;84(22):2224-8. doi: 10.1212/WNL.0000000000001637. Epub 2015 May 1.
To examine the impact of a healthy lifestyle on stroke risk in men at higher risk of stroke because of other cardiovascular diseases or conditions.
Our study population comprised 11,450 men in the Cohort of Swedish Men who had a history of hypertension, high cholesterol levels, diabetes, heart failure, or atrial fibrillation. Participants had completed a questionnaire about diet and lifestyle and were free from stroke and ischemic heart disease at baseline (January 1, 1998). We defined a healthy lifestyle as a low-risk diet (≥5 servings/d of fruits and vegetables and <30 g/d of processed meat), not smoking, ≥150 min/wk of physical activity, body mass index of 18.5 to 25 kg/m(2), and low to moderate alcohol consumption (>0 to ≤30 g/d). Ascertainment of stroke cases was accomplished through linkage with the National Inpatient Register and the Swedish Cause of Death Register.
During a mean follow-up of 9.8 years, we ascertained 1,062 incident stroke cases. The risk of total stroke and stroke types decreased with increasing number of healthy lifestyle factors. The multivariable relative risk of total stroke for men who achieved all 5 healthy lifestyle factors compared with men who achieved 0 or 1 factor was 0.28 (95% confidence interval 0.14-0.55). The corresponding relative risks (95% confidence interval) were 0.31 (0.15-0.66) for ischemic stroke and 0.32 (0.04-2.51) for hemorrhagic stroke.
A healthy lifestyle is associated with a substantially reduced risk of stroke in men at higher risk of stroke.
探讨健康生活方式对因其他心血管疾病或状况而具有较高卒中风险的男性卒中风险的影响。
我们的研究人群包括11450名瑞典男性队列中的男性，他们有高血压、高胆固醇血症、糖尿病、心力衰竭或心房颤动病史。参与者完成了一份关于饮食和生活方式的问卷，并且在基线时（1998年1月1日）没有卒中及缺血性心脏病。我们将健康生活方式定义为低风险饮食（每天至少5份水果和蔬菜且每天加工肉类摄入量<30克）、不吸烟、每周至少进行150分钟体育活动、体重指数为18.5至25千克/平方米以及低至中度饮酒（每天>0至≤30克）。通过与国家住院登记册和瑞典死亡原因登记册的关联来确定卒中病例。
在平均9.8年的随访期间，我们确定了1062例新发卒中病例。随着健康生活方式因素数量的增加，总卒中及卒中类型的风险降低。与实现0或1个健康生活方式因素的男性相比，实现所有5个健康生活方式因素的男性发生总卒中的多变量相对风险为0.28（95%置信区间0.14 - 0.55）。缺血性卒中的相应相对风险（95%置信区间）为0.31（0.15 - 0.66），出血性卒中的相应相对风险（95%置信区间）为0.32（0.04 - 2.51）。
健康生活方式与卒中风险较高的男性卒中风险大幅降低相关。
