• Nzechukwu M Isiozor, Setor K Kunutsor, Ari Voutilainen, Jussi Kauhanen, and Jari A Laukkanen.
• Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland. Electronic address: nzechukwu.isiozor@uef.fi.
• Prev Med. 2021 Dec 1; 153: 106858.

BackgroundPopulation-wide preventive measures constitute important approaches towards reducing stroke risk and its associated burden. We sought to examine the association between American Heart Association's (AHA) Life's Simple7 (LS7) score and the risk of stroke in men.MethodsThe study is based on the prospective population-based Kuopio Ischaemic Heart Disease cohort comprising men (42-60 years) without pre-existing history of stroke at baseline (1984-1989). LS7 was computed from AHA's cardiovascular health metrics for 2520 men and includes data on diet, physical activity, body mass index, smoking status, blood pressures, total cholesterol and blood glucose. Participants were classified into three LS7 groups based on the number of ideal metrics: low (0-2), medium (3-4) and high (5-7). Multivariable Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of LS7 scores for total and ischaemic stroke.ResultsDuring a median follow-up of 26 years, 428 total and 362 ischaemic incident stroke events were recorded. The risk of both stroke outcomes decreased continuously with increasing LS7 scores across the range 2-6. Men with high LS7 had 48% (HR: 0.52; 95%CI: 0.32-0.86) lower risk of total stroke when compared with those with low LS7. The association was similar for the risk of ischaemic stroke, with 50% (HR: 0.50; 95%CI: 0.29-0.87) lower risk among men with high LS7 compared with those with low LS7.ConclusionLS7 was strongly, inversely and linearly associated with risk of total and ischaemic strokes among a middle-aged male Finnish population.Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

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