Study finds healthy lifestyle can offset genetic risk

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Even people with a high genetic risk for stroke may be able to offset it by adopting a healthy lifestyle, according to a new study, Image Credit: Specker/Vedfelt/Getty Images.
  • Researchers have studied how cardiovascular health interacts with a high genetic risk of stroke.
  • They found that optimal cardiovascular health reduces the lifetime risk of stroke in people with high genetic risk.
  • Basic lifestyle interventions, such as following a healthy diet, exercising, and not smoking cigarettes, partially offset this risk.

Stroke is the second leading cause of death worldwide and a leading cause of disability and dementia. In the United States, adults aged 25 and older have a lifetime risk of stroke of about 24%.

Genetic and environmental factors influence the risk of stroke. The management of cardiometabolic risk factors and the promotion of healthy lifestyle habits are First line strategies to improve cardiovascular health and reduce the risk of stroke.

Recent genome-wide association studies have identified several stroke risk variants and have activated the development of genetic risk scores that predict the incidence of stroke.

It is unclear whether improved cardiovascular health can offset the genetic risk of stroke.

Recently, however, researchers have discovered that maintaining optimal cardiovascular health can partially offset an elevated genetic risk for stroke, thereby reducing overall lifetime stroke risk.

The study appears in the Journal of the American Heart Association.

“The public message is clear,” said Dr. Tatjana Rundek, professor of neurology and public health sciences at the University of Miami, not involved in the study. Medical News Today.

“Regardless of the potential for harboring ‘bad’ genetic risk, improving cardiovascular health should be the most important public health priority. Promoting ideal cardiovascular health should start at an early age, and many of us believe we should start with healthy eating and exercise from birth,” she noted.

For the study, researchers analyzed data from 11,568 middle-aged adults who had not had a stroke at baseline and followed them for an average of 28 years.

Their lifetime risk of stroke was estimated from genetic risk levels based on a validated polygenic stroke risk score and cardiovascular health levels according to the American Heart Association’s “life is simple 7“, which are now revised and updated to”The essentials of life 8.”

The initial recommendations of “Life’s Simple 7” are:

  • cholesterol control
  • blood pressure control
  • blood sugar control
  • physical activity
  • Balanced diet
  • maintain a healthy body mass index (BMI).

Participants were assessed for “Life’s Simple 7” at the start of the study from a mixture of self-reported and clinically assessed measures.

During the follow-up period, 1,138 participants were diagnosed with stroke. Of these, 14% presented a low genetic risk, 41.7% an intermediate genetic risk and 44.3% a high genetic risk.

The researchers further noted that participants with a low score on “Life’s Simple 7” suffered 56.8% of stroke events, while those with optimal “Life’s Simple 7” measures suffered 6.2% cerebrovascular accidents.

Overall, they found that participants with the highest genetic risk and lowest Life’s Simple 7 scores had the highest lifetime risk of stroke, at 24.8%.

They further found that across all polygenic risk score categories, those with an optimal “Life’s Simple 7” score had a 30-43% lower lifetime risk of stroke than those with a “Life’s Simple 7” score. was inadequate.

This, they noted, corresponded to 6 additional years of stroke-free life in people with the highest genetic risk.

Professor Lu Qi, Distinguished Chairman and Professor in the Department of Epidemiology at Tulane University School of Public Health and Tropical Medicine, not involved in the study, said DTM:

“‘Life is simple 7’ [has] have been linked to lower genetic risks of cardiovascular disease, including stroke, in previous studies. It is not surprising that the optimal score “Life’s Simple 7” is associated with a risk of stroke associated with lower genetic variation. »

When asked how “Life’s Simple 7” might reduce genetic stroke risk.

Professor Rundek said that “[t]The exact mechanism by which combined risk/lifestyle factors and genetic factors affect stroke risk is unknown and likely complex.

“One way to explain how ideal cardiovascular health – ‘Life’s Simple 7’ – can reduce genetic stroke risk is to think about genetic susceptibility to stroke risk in the presence of ‘Life’s Simple 7’ deleterious factors, because some genes can only be expressed when activated by the presence of environmental factors or a bad ‘Life’s Simple 7’ [scores for] cardiovascular health,” she noted.

“If we reduce these environmental factors and achieve ideal cardiovascular health” Life’s Simple 7 ” [score] – the stroke risk genes that we potentially harbor – would not be expressed to harm and contribute to an increased risk of stroke,” Professor Rundek added.

The researchers concluded that maintaining optimal cardiovascular health may partially offset a high genetic risk for stroke.

Asked about the study’s limitations, Professor Qi noted that because the study was observational in nature, it is “limited for causal inference”.

Professor Christie M. Ballantyne, chief of cardiology at Baylor University, also not involved in the study, further pointed out that:

“Data on African Americans was not strong, and other racial and ethnic groups, such as Hispanics, South Asians, and East Asians, were not well represented in this study. Additional studies in other populations are needed to optimize polygenic risk scores so that they are more useful in clinical practice for all of our patients.

Professor Rundek added that “[i]Achieving and Maintaining Life’s Simple 7 Cardiovascular Ideal Can Be Difficult [score] whether there is a high individual genetic susceptibility to the risk of stroke [which includes] an increased risk of hypertension and other ‘Life’s Simple 7’ factors.

“In addition, some genetic markers – rare alleles – are not included in polygenic risk scores because they contribute to risk only to a small extent. However, they may have a cumulative effect if present in an individual. . […] How changes in “Life’s Simple 7” factors over time affect genetic risk is also an interesting question. All of these should be carefully considered in future studies,” she explained.


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