Genetic risk, incident stroke, and the benefits of adhering to a healthy lifestyle: cohort study of 306 473 UK Biobank participants.
cam.issuedOnline | 2018-10-24 | |
dc.contributor.author | Rutten-Jacobs, Loes Ca | |
dc.contributor.author | Larsson, Susanna C | |
dc.contributor.author | Malik, Rainer | |
dc.contributor.author | Rannikmäe, Kristiina | |
dc.contributor.author | MEGASTROKE consortium | |
dc.contributor.author | International Stroke Genetics Consortium | |
dc.contributor.author | Sudlow, Cathie L | |
dc.contributor.author | Dichgans, Martin | |
dc.contributor.author | Markus, Hugh S | |
dc.contributor.author | Traylor, Matthew | |
dc.contributor.orcid | Rutten-Jacobs, Loes Ca [0000-0003-3223-885X] | |
dc.date.accessioned | 2018-12-04T00:30:57Z | |
dc.date.available | 2018-12-04T00:30:57Z | |
dc.date.issued | 2018-10-24 | |
dc.description.abstract | OBJECTIVE: To evaluate the associations of a polygenic risk score and healthy lifestyle with incident stroke. DESIGN: Prospective population based cohort study. SETTING: UK Biobank Study, UK. PARTICIPANTS: 306 473 men and women, aged 40-73 years, recruited between 2006 and 2010. MAIN OUTCOME MEASURE: Hazard ratios for a first stroke, estimated using Cox regression. A polygenic risk score of 90 single nucleotide polymorphisms previously associated with stroke was constructed at P<1×10-5 to test for an association with incident stroke. Adherence to a healthy lifestyle was determined on the basis of four factors: non-smoker, healthy diet, body mass index <30 kg/m2, and regular physical exercise. RESULTS: During a median follow-up of 7.1 years (2 138 443 person years), 2077 incident strokes (1541 ischaemic stroke, 287 intracerebral haemorrhage, and 249 subarachnoid haemorrhage) were ascertained. The risk of incident stroke was 35% higher among those at high genetic risk (top third of polygenic score) compared with those at low genetic risk (bottom third): hazard ratio 1.35 (95% confidence interval 1.21 to 1.50), P=3.9×10-8. Unfavourable lifestyle (0 or 1 healthy lifestyle factors) was associated with a 66% increased risk of stroke compared with a favourable lifestyle (3 or 4 healthy lifestyle factors): 1.66 (1.45 to 1.89), P=1.19×10-13. The association with lifestyle was independent of genetic risk stratums. CONCLUSION: In this cohort study, genetic and lifestyle factors were independently associated with incident stroke. These results emphasise the benefit of entire populations adhering to a healthy lifestyle, independent of genetic risk. | |
dc.format.medium | Electronic | |
dc.identifier.doi | 10.17863/CAM.33570 | |
dc.identifier.eissn | 1756-1833 | |
dc.identifier.issn | 0959-8146 | |
dc.identifier.uri | https://www.repository.cam.ac.uk/handle/1810/286258 | |
dc.language | eng | |
dc.language.iso | eng | |
dc.publisher | BMJ | |
dc.publisher.url | http://dx.doi.org/10.1136/bmj.k4168 | |
dc.rights | Attribution 4.0 International | |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | |
dc.subject | Adult | |
dc.subject | Aged | |
dc.subject | Cerebral Hemorrhage | |
dc.subject | Exercise | |
dc.subject | Female | |
dc.subject | Genetic Predisposition to Disease | |
dc.subject | Healthy Lifestyle | |
dc.subject | Humans | |
dc.subject | Incidence | |
dc.subject | Male | |
dc.subject | Middle Aged | |
dc.subject | Multifactorial Inheritance | |
dc.subject | Myocardial Infarction | |
dc.subject | Patient Compliance | |
dc.subject | Polymorphism, Single Nucleotide | |
dc.subject | Prospective Studies | |
dc.subject | Risk Factors | |
dc.subject | Stroke | |
dc.subject | Subarachnoid Hemorrhage | |
dc.subject | United Kingdom | |
dc.title | Genetic risk, incident stroke, and the benefits of adhering to a healthy lifestyle: cohort study of 306 473 UK Biobank participants. | |
dc.type | Article | |
dcterms.dateAccepted | 2018-09-17 | |
prism.publicationDate | 2018 | |
prism.publicationName | BMJ | |
prism.startingPage | k4168 | |
prism.volume | 363 | |
pubs.funder-project-id | British Heart Foundation (RG/16/4/32218) | |
pubs.funder-project-id | British Heart Foundation (FS/15/61/31626) | |
rioxxterms.licenseref.startdate | 2018-10-24 | |
rioxxterms.licenseref.uri | http://www.rioxx.net/licenses/all-rights-reserved | |
rioxxterms.type | Journal Article/Review | |
rioxxterms.version | VoR | |
rioxxterms.versionofrecord | 10.1136/bmj.k4168 |
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