Interplay of Acquired Risk Factors, Age, and Genetic Predisposition in Incident Stroke: A Prospective Cohort Study
Background Stroke is the leading cause of disability and death worldwide, and its pathogenesis involves various risk factors. This study aimed to investigate the associations between acquired risk factors, age, and genetic predisposition in the incidence of stroke. Methods and Results We analyzed 40...
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Wiley
2025-07-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.125.040962 |
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| author | Yu‐Biao Wu Ze‐Gui Huang Wan‐Bing He Si You Shao‐Ling Zhang Yang‐Wei Cai Yuan‐Li Meng Qing‐Yuan Gao Jing‐Feng Wang Hai‐Feng Zhang Jing‐Wei Gao Pin‐Ming Liu |
| author_facet | Yu‐Biao Wu Ze‐Gui Huang Wan‐Bing He Si You Shao‐Ling Zhang Yang‐Wei Cai Yuan‐Li Meng Qing‐Yuan Gao Jing‐Feng Wang Hai‐Feng Zhang Jing‐Wei Gao Pin‐Ming Liu |
| author_sort | Yu‐Biao Wu |
| collection | DOAJ |
| description | Background Stroke is the leading cause of disability and death worldwide, and its pathogenesis involves various risk factors. This study aimed to investigate the associations between acquired risk factors, age, and genetic predisposition in the incidence of stroke. Methods and Results We analyzed 404 873 participants (age, mean±SD, 56.46±8.10 years; 45.97% men) from the UK Biobank cohort, all without a history of stroke at baseline and with complete information on risk factors. Hazard ratios and population‐attributable risk percentages for incident stroke were calculated for 21 risk factors, including 3 social determinants, 8 unhealthy behaviors, 4 metabolic factors, 5 clinical comorbidities, and 1 genetic risk score. Participants were stratified by age and genetic risk. During a 4.8 million person‐year follow‐up, 8287 participants (2.05%) experienced a stroke. Metabolic factors, particularly hypertension, were key contributors to stroke risk across all age and genetic groups (population‐attributable risk percentages, 26.53–38.63 and 28.05–37.09). Stroke risk due to overall metabolic factors increased with higher genetic risk (population‐attributable risk percentages, 28.05 in low‐risk and 37.09 in high‐risk groups). The effects of certain risk factors, such as dietary risk and hypertension, were more pronounced in participants with higher genetic risk. The contributions of social factors and clinical comorbidities to stroke risk were relatively low across genetic risk groups. Conclusions Metabolic factors, especially hypertension, are critical targets for stroke prevention across diverse age and genetic risk profiles. Tailored prevention strategies that address modifiable risk factors, considering individual age and genetic predisposition, have the potential to significantly reduce stroke incidence. |
| format | Article |
| id | doaj-art-b6fd0127b5a74b99b173f2700488c58f |
| institution | Matheson Library |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-b6fd0127b5a74b99b173f2700488c58f2025-07-16T10:09:52ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-07-01141410.1161/JAHA.125.040962Interplay of Acquired Risk Factors, Age, and Genetic Predisposition in Incident Stroke: A Prospective Cohort StudyYu‐Biao Wu0Ze‐Gui Huang1Wan‐Bing He2Si You3Shao‐Ling Zhang4Yang‐Wei Cai5Yuan‐Li Meng6Qing‐Yuan Gao7Jing‐Feng Wang8Hai‐Feng Zhang9Jing‐Wei Gao10Pin‐Ming Liu11Department of Cardiology, Sun Yat‐sen Memorial Hospital Sun Yat‐sen University Guangzhou ChinaDepartment of Cardiology, Sun Yat‐sen Memorial Hospital Sun Yat‐sen University Guangzhou ChinaDepartment of Cardiology, Sun Yat‐sen Memorial Hospital Sun Yat‐sen University Guangzhou ChinaDepartment of Cardiology, Sun Yat‐sen Memorial Hospital Sun Yat‐sen University Guangzhou ChinaDepartment of Endocrinology, Sun Yat‐sen Memorial Hospital Sun Yat‐sen University Guangzhou ChinaDepartment of Cardiology, Sun Yat‐sen Memorial Hospital Sun Yat‐sen University Guangzhou ChinaDepartment of Cardiology, Sun Yat‐sen Memorial Hospital Sun Yat‐sen University Guangzhou ChinaDepartment of Cardiology, Sun Yat‐sen Memorial Hospital Sun Yat‐sen University Guangzhou ChinaDepartment of Cardiology, Sun Yat‐sen Memorial Hospital Sun Yat‐sen University Guangzhou ChinaDepartment of Cardiology, Sun Yat‐sen Memorial Hospital Sun Yat‐sen University Guangzhou ChinaDepartment of Cardiology, Sun Yat‐sen Memorial Hospital Sun Yat‐sen University Guangzhou ChinaDepartment of Cardiology, Sun Yat‐sen Memorial Hospital Sun Yat‐sen University Guangzhou ChinaBackground Stroke is the leading cause of disability and death worldwide, and its pathogenesis involves various risk factors. This study aimed to investigate the associations between acquired risk factors, age, and genetic predisposition in the incidence of stroke. Methods and Results We analyzed 404 873 participants (age, mean±SD, 56.46±8.10 years; 45.97% men) from the UK Biobank cohort, all without a history of stroke at baseline and with complete information on risk factors. Hazard ratios and population‐attributable risk percentages for incident stroke were calculated for 21 risk factors, including 3 social determinants, 8 unhealthy behaviors, 4 metabolic factors, 5 clinical comorbidities, and 1 genetic risk score. Participants were stratified by age and genetic risk. During a 4.8 million person‐year follow‐up, 8287 participants (2.05%) experienced a stroke. Metabolic factors, particularly hypertension, were key contributors to stroke risk across all age and genetic groups (population‐attributable risk percentages, 26.53–38.63 and 28.05–37.09). Stroke risk due to overall metabolic factors increased with higher genetic risk (population‐attributable risk percentages, 28.05 in low‐risk and 37.09 in high‐risk groups). The effects of certain risk factors, such as dietary risk and hypertension, were more pronounced in participants with higher genetic risk. The contributions of social factors and clinical comorbidities to stroke risk were relatively low across genetic risk groups. Conclusions Metabolic factors, especially hypertension, are critical targets for stroke prevention across diverse age and genetic risk profiles. Tailored prevention strategies that address modifiable risk factors, considering individual age and genetic predisposition, have the potential to significantly reduce stroke incidence.https://www.ahajournals.org/doi/10.1161/JAHA.125.040962agegenetic predispositionhypertensionrisk factorsstroke |
| spellingShingle | Yu‐Biao Wu Ze‐Gui Huang Wan‐Bing He Si You Shao‐Ling Zhang Yang‐Wei Cai Yuan‐Li Meng Qing‐Yuan Gao Jing‐Feng Wang Hai‐Feng Zhang Jing‐Wei Gao Pin‐Ming Liu Interplay of Acquired Risk Factors, Age, and Genetic Predisposition in Incident Stroke: A Prospective Cohort Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease age genetic predisposition hypertension risk factors stroke |
| title | Interplay of Acquired Risk Factors, Age, and Genetic Predisposition in Incident Stroke: A Prospective Cohort Study |
| title_full | Interplay of Acquired Risk Factors, Age, and Genetic Predisposition in Incident Stroke: A Prospective Cohort Study |
| title_fullStr | Interplay of Acquired Risk Factors, Age, and Genetic Predisposition in Incident Stroke: A Prospective Cohort Study |
| title_full_unstemmed | Interplay of Acquired Risk Factors, Age, and Genetic Predisposition in Incident Stroke: A Prospective Cohort Study |
| title_short | Interplay of Acquired Risk Factors, Age, and Genetic Predisposition in Incident Stroke: A Prospective Cohort Study |
| title_sort | interplay of acquired risk factors age and genetic predisposition in incident stroke a prospective cohort study |
| topic | age genetic predisposition hypertension risk factors stroke |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.125.040962 |
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