Small lifestyle changes may have big impact on reducing stroke risk

Researchers assessed stroke risk using the American Heart Association's Life's Simple 7 health factors: be active, control cholesterol, eat a healthy diet, manage blood pressure, maintain a healthy weight, control blood sugar and don't smoke.

"We used the assessment tool to look at stroke risk and found that small differences in health status were associated with large reductions in stroke risk," said Mary Cushman, M.D., M.Sc., senior author and professor of medicine at the University of Vermont in Burlington.

Researchers divided the Life's Simple 7 scores into three categories: zero to four points for inadequate, five to nine points for average, and 10 to 14 points for optimum cardiovascular health.

Researchers found:

• Every one-point increase toward a better score was associated with an 8 percent lower stroke risk.
• Compared to those with inadequate scores, people with optimum scores had a 48 percent lower stroke risk and those with average scores had a 27 percent lower stroke risk.
• A better score was associated with a similar reduced stroke risk in blacks and whites.

While black participants had worse Life's Simple 7 scores than whites, the association of the Life's Simple 7 score with stroke risk was similar in black and white participants. "This highlights the critical importance of improving these health factors since blacks have nearly twice the stroke mortality rates as whites," Cushman said.

Cushman and colleagues reviewed information on 22,914 black and white Americans age 45 and older who are participating in a nationwide population-based study called the Reasons for Geographic and Racial Differences in Stroke (REGARDS).

Researchers collected data in 2003-07 by telephone, self-administered questionnaires and at-home exams. Participants were followed for 5 years for stroke. Many of the study participants live in the Southeast region of the United States where death rates from stroke are the highest.

During the study, 432 strokes occurred. All seven health factors in Life's Simple 7 played an important role in predicting the risk for stroke, but having ideal blood pressure was the most important indicator of stroke risk, researchers said.

"Compared to those with poor blood pressure status, those who were ideal had a 60 percent lower risk of future stroke," Cushman said.

Researchers also found that those who didn't smoke or quit smoking more than one year prior to the beginning of the study had a 40 percent lower stroke risk.

Each year, about 795,000 people in the United States have a stroke -- the No. 4 killer and a leading cause of long-term disability. Every four minutes, an American dies from stroke. People can check their health status at www.mylifecheck.org.