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Health & Medicine for Senior Citizens

Small Lifestyle Change Has Big Impact on Reducing Risk of Highly Feared Strokes

Study finds the risk drops rapidly with lifestyle changes measured with AHA’s Simple 7

Copyright American Heart Association Source - American Heart Association's journal Stroke: M. Cushman

June 6, 2013 – Most senior citizens are usually battling one health threat or another, but, there are certain ailments that are more feared than others. Alzheimer’s, the mind-destroyer, always ranks first. But right up there with it is another mind-wrecker - stroke. A new study, however, offers encouragement that seniors can make just small changes in their lifestyle and make a big reduction in their risk of a stroke.

Stroke is a leading cause of death and disability in the U.S. that are caused by abnormal changes in blood flow in the brain or the bursting of brain blood vessels.

In a new study reported in the American Heart Association’s journal Stoke, researchers used a stroke assessment tool developed by the association and named Life’s Simple 7 - be active, control cholesterol, eat a healthy diet, manage blood pressure, maintain a healthy weight, control blood sugar and don't smoke.


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Each factor was scored as 0 (poor compliance), 1 (intermediate compliance), or 2 (ideal compliance), with overall total scores grouped into three categories such that a score of 0-4 indicates poor cardiovascular health, 5-9 average health, and 10-14 represents optimal health.

"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.

They found:

   ● Every one-point increase toward a better score there was 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.

The results back up previous studies that show strokes can be prevented by reducing these risk factors for cardiovascular disease.

In 2010, the American Heart Association/American Stroke Association defined seven critical risk factors as: elevated blood pressure, cholesterol, and blood glucose, obesity, current smoking, physical inactivity, and poor diet and then used them to create the cardiovascular health score called Life's Simple 7.

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


Co-authors are Ambar Kulshreshtha, M.D., M.P.H. (first author); Viola Vaccarino, M.D., Ph.D.; Suzanne Judd, Ph.D.; Virginia J. Howard, Ph.D.; William McClellan, M.D., M.P.H.; Paul Muntner, Ph.D.; Yuling Hong, M.D., Ph.D.; Monika M. Safford, M.D. and Abhinav Goyal, M.D., M.H.S. Author disclosures are on the manuscript.

REGARDS is funded by a cooperative agreement from the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health and Human Service.

For more information about stroke.

NINDS is the nation's leading funder of research on the brain and nervous system. The NINDS mission is to reduce the burden of neurological disease – a burden borne by every age group, by every segment of society, by people all over the world.

About the National Institutes of Health (NIH)

NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit

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