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Harshfield EL, Georgakis MK, Malik R, et al. Modifiable Lifestyle Factors and Risk of Stroke: A Mendelian Randomization Analysis. Stroke. 2021;52(3):931-936doi: 10.1161/STROKEAHA.120.031710.
Harshfield, E. L., Georgakis, M. K., Malik, R., Dichgans, M., & Markus, H. S. (2021). Modifiable Lifestyle Factors and Risk of Stroke: A Mendelian Randomization Analysis. Stroke, 52(3), 931-936. https://doi.org/10.1161/STROKEAHA.120.031710
Harshfield, Eric L, et al. "Modifiable Lifestyle Factors and Risk of Stroke: A Mendelian Randomization Analysis." Stroke vol. 52,3 (2021): 931-936. doi: https://doi.org/10.1161/STROKEAHA.120.031710
Harshfield EL, Georgakis MK, Malik R, Dichgans M, Markus HS. Modifiable Lifestyle Factors and Risk of Stroke: A Mendelian Randomization Analysis. Stroke. 2021 Mar;52(3):931-936. doi: 10.1161/STROKEAHA.120.031710. Epub 2021 Feb 04. PMID: 33535786; PMCID: PMC7903981.
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Stroke. 2021 Mar;52(3):931-936. doi: 10.1161/STROKEAHA.120.031710. Epub 2021 Feb 04.

Modifiable Lifestyle Factors and Risk of Stroke: A Mendelian Randomization Analysis.

Stroke

Eric L Harshfield, Marios K Georgakis, Rainer Malik, Martin Dichgans, Hugh S Markus

Affiliations

  1. Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, United Kingdom (E.L.H., H.S.M.).
  2. Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilians-University, Munich, Germany (M.K.G., R.M., M.D.).
  3. Graduate School for Systemic Neurosciences, Ludwig Maximilians University, Munich, Germany (M.K.G.).
  4. Munich Cluster for Systems Neurology (SyNergy), Germany (M.D.).
  5. German Centre for Neurodegenerative Diseases (DZNE), Munich, Germany (M.D.).

PMID: 33535786 PMCID: PMC7903981 DOI: 10.1161/STROKEAHA.120.031710

Abstract

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.

Keywords: Mendelian randomization analysis; body mass index; educational status; genetics; risk factors; smoking; stroke

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