Each year, about 700,000 Americans have a stroke . About 25% of these strokes are fatal, and another 25% leave their victims permanently disabled. There are two types of stroke. Ischemic strokes occur when blood flow to the brain is blocked. Hemorrhagic strokes occur when a ruptured blood vessel leaks blood into the brain.

Studies have shown that individual healthy behaviors such as not smoking and maintaining a low body mass index (BMI) can affect stroke risk. But how does an overall lifestyle combining several healthy behaviors affect the risk of stroke?

In a study published in the July 10, 2006 Archives of Internal Medicine , researchers report that women with the healthiest lifestyles (characterized by not smoking, moderate alcohol consumption, regular exercise, lower body mass index, and a healthful diet) had a significantly lower risk of overall stroke and ischemic stroke compared to women with the least healthy lifestyles. A healthier lifestyle did not seem to reduce the risk of hemorrhagic stroke.

About the Study

The researchers analyzed data on 37,636 women, age 45 years and older, who were enrolled in the Women’s Health Study (WHS). Upon enrollment, the women filled out a questionnaire about their smoking and exercise habits, BMI, alcohol consumption, and diet.

For this study, the researchers assigned the women a health index score, ranging from 0-20 (with higher scores reflecting a healthier lifestyle), based on their responses in the five categories. They followed the women for ten years, noting the number and types of strokes that occurred during this time, and analyzed the relationship between health index score and risk of stroke.

Women with health index scores of 17-20 were 55% less likely to have any type of stroke and 71% less likely to have an ischemic stroke compared to women with a health index score of 0-4. Every additional point on the health index score reduced the risk of any stroke by 5% and of ischemic stroke by 6%. A healthier lifestyle did not reduce the risk of hemorrhagic stroke.

This study had at least one important limitation. The study participants answered questions about lifestyle factors at the beginning of the study, but never again during the ten-year follow-up. If the women changed their health behaviors during the study period, this would have affected their health index scores and possibly altered some of the study’s findings.

How Does This Affect You?

This study found that women with the healthiest lifestyles had a significantly lower risk of overall stroke and ischemic stroke than women with the least healthy lifestyles. Medications can help reduce the risk of stroke, especially in patients with high blood pressure. But these medications alone are insufficient for stroke prevention. So it is encouraging to find that women can modify their risk by adopting healthy behaviors: not smoking, drinking moderately, exercising regularly, eating sensibly, and maintaining a low BMI.

It can be intimidating to think that you have to be among the healthiest of women to reap the benefits of a healthy lifestyle. But this study also showed that as health index scores increased, the risk of stroke and ischemic stroke decreased. This suggests that any steps you take—from exercising a few more times a week to losing a few pounds—may help lower your risk of stroke.