期刊
STROKE
卷 52, 期 3, 页码 931-936出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/STROKEAHA.120.031710
关键词
body mass index; educational status; genetics; Mendelian randomization analysis; risk factors; smoking; stroke
资金
- British Heart Foundation [RG/16/4/32218]
- European Union Horizon 2020 [667375, 666881]
- Cambridge University Hospitals National Institute for Health Research* Biomedical Research Centre
- Onassis Foundation
- Deutsche Forschungsgemeinschaft [EXC1010-SyNergy]
- Corona Foundation
- Fondation Leducq (Transatlantic Networks of Excellence Program on Pathogenesis of Small Vessel Disease of Brain)
- National Institute for Health Research
- Ludwig-MaximiliansUniversity-University of Cambridge strategic collaboration grant
Genetic studies show that education level, smoking, and body mass index are causally associated with the risk of ischemic stroke, with their effects acting independently. These findings suggest that modifying lifestyle factors may reduce the risk of stroke.
Background and Purpose: Assessing whether modifiable risk factors are causally associated with stroke risk is important in planning public health measures, but determining causality can be difficult in epidemiological data. We evaluated whether modifiable lifestyle factors including educational attainment, smoking, and body mass index are causal risk factors for ischemic stroke and its subtypes and hemorrhagic stroke. Methods: We performed 2-sample and multivariable Mendelian randomization to assess the causal effect of 12 lifestyle factors on risk of stroke and whether these effects are independent. Results: Genetically predicted years of education was inversely associated with ischemic, large artery, and small vessel stroke, and intracerebral hemorrhage. Genetically predicted smoking, body mass index, and waist-hip ratio were associated with ischemic and large artery stroke. The effects of education, body mass index, and smoking on ischemic stroke were independent. Conclusions: Our findings support the hypothesis that reduced education and increased smoking and obesity increase risk of ischemic, large artery, and small vessel stroke, suggesting that lifestyle modifications addressing these risk factors will reduce stroke risk.
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