Lifestyle Factors and Antihypertensive Treatment on the Risks of Ischemic and Hemorrhagic Stroke

The joint relationship between healthy lifestyle and antihypertensive treatment with stroke risk is unclear. We prospectively investigated the individual and joint effects of healthy lifestyle factors and antihypertensive treatment on stroke risk among 36 686 Finnish participants aged 25 to 74 years and free of coronary heart disease and stroke at baseline. During a mean follow-up of 13.7 years, 1478 people developed stroke event (1167 ischemic and 311 hemorrhagic). The stroke risk was significantly decreased in people who adhered to ≥3 healthy lifestyle factors (never smoking, normal weight, moderate/high level of exercise, vegetable consumption ≥3 times per week, and light/moderate alcohol drinking) compared with those who adhered to <3 healthy lifestyle factors. The stroke risk was significantly increased in unaware untreated, aware untreated, aware treated and controlled, and aware treated and uncontrolled hypertensive people than in normotensive people. The risks of stroke were decreased in people who adhered to ≥3 healthy lifestyle factors compared with those who adhered to <3 healthy lifestyle factors within different hypertensive status. Compared with hypertensive people who did not use antihypertensive drugs and adhered to ≥3 healthy lifestyle factors, the multivariable-adjusted hazard ratios in hypertensive people who used antihypertensive drugs and adhered to <3 healthy lifestyle factors were associated with 37% to 42% increased risks of total, ischemic, and hemorrhagic stroke in men and 121% to 131% increased risks of stroke in women. The present study demonstrates that a healthy lifestyle significantly decreases stroke risk in both men and women in different strata of hypertension status and antihypertensive drug treatments.