Healthy lifestyle and the risk of stroke in women.
Healthy lifestyle and the risk of stroke in women.
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DOI：
10.1097/00008483-200611000-00013
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发表时间：
2006-07
影响因子：
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通讯作者：
T. Kurth;Steven C. Moore;J. Gaziano;Carlos S. Kase;M. Stampfer;K. Berger;Julie E. Buring
中科院分区：
文献类型：
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作者：
T. Kurth;Steven C. Moore;J. Gaziano;Carlos S. Kase;M. Stampfer;K. Berger;Julie E. Buring
背景技术健康的生活方式与冠心病风险降低相关。相比之下，人们对其与中风风险的关系知之甚少。方法 这是一项前瞻性队列研究，共有 37 636 名 45 岁或以上的女性参与女性健康研究。中风是自我报告并通过病历审查确认的。我们考虑了以下自我报告的生活方式因素：吸烟、饮酒、运动、体重指数和饮食。健康指数是根据这些变量计算出来的，为各个变量类别分配 0 到 4 的分数，分数越高表明行为越健康。健康行为的定义是：从不吸烟，每周饮酒4至10.5杯，每周运动4次或以上，体重指数（以千克为单位的体重除以米为单位的身高的平方计算）低于22，饮食中富含谷物纤维、叶酸和omega-3脂肪酸，多不饱和脂肪与饱和脂肪的比例较高，反式脂肪和血糖负荷较低。结果 在 10 年的随访期间，确诊了 450 例中风（356 例缺血性中风，90 例出血性中风，4 例未明确中风）。与健康指数为 0 至 4 分的参与者 (4.3%) 相比，健康指数为 17 至 20 分的女性 (4.7%) 的总卒中多变量调整风险比（95% 置信区间）为 0.45（0.24-0.83；趋势 P<.001），缺血性卒中为 0.29（0.14-0.63；趋势 P<.001）， 1.27 出血性中风（0.37-4.29；趋势 P = .62）。结论 在这个由表面上健康的女性组成的大型前瞻性队列中，由戒烟、低体重指数、适量饮酒、定期锻炼和健康饮食组成的健康生活方式与完全性和缺血性中风风险显着降低相关，但与出血性中风风险无关。我们的研究结果强调了健康行为对于预防中风的重要性。
BACKGROUND Healthy lifestyle has been associated with decreased risk of coronary heart disease. In contrast, little is known about its association with stroke risk. METHODS This is a prospective cohort study among 37 636 women 45 years or older participating in the Women's Health Study. Stroke was self-reported and confirmed by means of medical record review. We considered the following self-reported lifestyle factors: smoking, alcohol consumption, exercise, body mass index, and diet. The health index was calculated from these variables by assigning scores from 0 to 4 to the respective variable categories, with a higher score indicating healthier behavior. Healthy behavior was defined as never smoking, alcohol consumption between 4 and 10.5 drinks per week, exercise 4 or more times per week, body mass index (calculated as weight in kilograms divided by the square of height in meters) less than 22, and a diet high in cereal fiber, folate, and omega-3 fatty acids, with a high ratio of polyunsaturated to saturated fat, and low in trans fat and glycemic load. RESULTS During 10 years of follow-up, 450 strokes (356 ischemic, 90 hemorrhagic, and 4 undefined) were confirmed. Compared with participants with 0 to 4 health index points (4.3%), women with 17 to 20 health index points (4.7%) had multivariable-adjusted hazard ratios (95% confidence interval) of 0.45 (0.24-0.83; P<.001 for trend) for total stroke, 0.29 (0.14-0.63; P<.001 for trend) for ischemic stroke, and 1.27 (0.37-4.29; P = .62 for trend) for hemorrhagic stroke. CONCLUSIONS In this large prospective cohort of apparently healthy women, a healthy lifestyle consisting of abstinence from smoking, low body mass index, moderate alcohol consumption, regular exercise, and healthy diet was associated with a significantly reduced risk of total and ischemic stroke but not of hemorrhagic stroke. Our findings underscore the importance of healthy behaviors in the prevention of stroke.