HealthDay News – Hypertension, smoking and other changeable factors may account for about 50% of all strokes, according to researchers.

“Data suggests that half of all strokes in patients 55 years and over might theoretically be prevented by optimal treatment or elimination of hypertension, smoking, diabetes mellitus, atrial fibrillation, coronary disease, and overweight/obesity,” said researchers in a study published by PLOS Medicine.

In order to estimate the proportion of strokes that could theoretically be prevented by eliminating some factors from the population, Michiel J. Bos, MD and colleagues from the Eramus Medical Center assessed the population attributable risks for factors individually and in combination. To examine the potentially modifiable etiological factors occurring in stroke, researchers surveyed 6,844 patients.

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During a mean follow-up of 12.9 years, researchers identified 1,020 strokes. The combined PAR was .51 for pre-hypertension/hypertension, smoking, diabetes mellitus, atrial fibrillation, coronary diseases, and obesity, after adjusting for age and gender.

Hypertension and smoking were the most important etiological factors. The total PAR was raised by .06 by the combination of C-reactive protein, fruit and vegetable consumption and carotid intima-media thickness.

The PARs for ischemic stroke and hemorrhagic stroke were .55 and .70, respectively.

“About half of all strokes are attributable to established causal and modifiable factors,” wrote the authors. “This finding encourages not only intervention on established etiological factors, but also further study of less well established factors.”


  1. Bos, M et al. PLOS Medicine. 2014; doi: 10.1371/journal.pmed.1001634